Open AccessAn Interesting Case of Dysphagia in a HIV Patient
Author(s) -
Deepak Madi,
Basavaprabhu Achappa,
John T Ramapuram,
Nithyananda K Chowta,
Soundarya Mahalingaman
Publication year - 2013
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2013/4741.2815
Subject(s) - medicine , dysphagia , tuberculosis , mediastinal lymphadenopathy , pneumomediastinum , fistula , sputum , surgery , mediastinum , miliary tuberculosis , esophagus , radiology , human immunodeficiency virus (hiv) , esophageal ulcer , biopsy , dermatology , complication , pathology , family medicine
Oesophageal tuberculosis is a rare disease. Tuberculosis (TB) can cause dysphagia due to oesophageal ulcers, Tracheo-Oesophageal Fistulas (TOFs) and an extrinsic compression which is caused by the mediastinal lymph nodes. A 33-year-old gentleman was admitted to our hospital for the evaluation of fever, dysphagia and cough. His chest X-ray was suggestive of miliary tuberculosis. A CT scan of his chest revealed miliary tuberculosis, mediastinal lymphadenopathy and pneumomediastinum. His sputum AFB (acid-fast bacilli) test was positive. An upper gastrointestinal endoscopy revealed a large ulcer in the oesophagus with a fistulous opening which was suggestive of a tracheo-oesophageal fistula. A biopsy from the ulcer was positive for AFB. The test for HIV-1 was positive. A nasogastric feeding tube was placed and the Anti Tubercular Therapy ( ATT) was started. The main aim of this case report is to sensitize the clinicians about the fact that Tuberculosis can present with dysphagia, especially in HIV patients.