Tuberculous abscess of the abdominal wall and multiple splenic abscesses in an immunocompetent patient.

We report a case of a 39-year-old human immunodeficiency virus (HIV)--negative male who presented with a progressively increasing swelling in the left hypochondrium. He did not manifest fever or toxaemic symptoms. Computerised tomographic scan (CT scan) of the abdomen revealed an abscess in the anterior wall and multiple splenic abscesses. Fine needle aspiration from the abscesses in the anterior abdominal wall and the spleen confirmed the diagnosis of tuberculosis as the aetiology. The patient responded well to antituberculosis treatment and the abscesses regressed considerably.

Primary MDR-TB of the breast.

A 28-year-old, lactating lady presented to us with left-sided breast abscess and lymph node enlargement in the left axillary region for the past one and a half months. Investigations revealed the breast abscess and axillary lymphadenopathy were tubercular in origin. The patient was put on standard four-drug anti-tubercular treatment (rifampicin, isoniazid, ethambutol and pyrazinamide). The patient did not respond to the intensive four-drug therapy, which was continued for three months. The culture isolate of the breast abscess grew M. tuberculosis, which was resistant to isoniazid, rifampicin and streptomycin. The patient was then retreated with a regimen comprising--kanamycin, ofloxacin, ethionamide para-amino salicyclic acid (PAS), pyrazinamide and isoniazid, from which the patient benefited and recovered.

Clinical profile of tuberculosis in patients with HIV Infection/AIDS.

Tuberculosis is said to be one of the commonest opportunistic infection in patients with HIV/ AIDS. A study was carried out to study the clinical, bacteriological and radiological features of HIV/TB patients. Over a period of two years, a total of 301 tuberculosis patients were suspected to have HIV/AIDS co-infection, and upon testing, 42 patients were found to be HIV seropositive. Most of the study patients were manual labourers followed by truck drivers. Sexual (heterosexual) route was found to be the major risk factor for HIV/AIDS. The most common symptom in these patients was cough and expectoration, followed by fever and weight loss. Acid-fast bacilli (AFB) smear positivity was found in 21.4% patients. On chest skiagram, infiltrative lesions were commonly seen in 61.9% patients. Extra-pulmonary tubercular manifestations were seen in 45.6% of HIV/TB cases.

Miliary tuberculosis with bilateral pneumothorax: a rare complication.

A 15-year-old girl presented with a history of cough, fever for five months and breathlessness of two days duration. Her chest roentgenogram showed bilateral miliary shadows with a left sided pneumothorax. Shortly afterwards, she developed a pneumothorax on the other side also. She was managed with intercostal tube drainage on both sides and antitubercular treatment. She made an uneventful recovery.