Background. The emergence of Human immunodeficiency virus (HIV), led to the rise in the incidence and prevalence of tuberculosis (TB) worldwide. However, the trend is being reversed recently due to the widespread use of effective Anti-Retrovirals. Immunosuppression induced by HIV infection modified the clinical presentation of TB, resulting in atypical signs and symptoms, and a more frequent extrapulmonary presentation. This study was undertaken to determine the pattern of presentation and prevalence of TB in HIV seropositive patients seen in Benin City, Nigeria, from January to April, 2007. Method. The study was done using 330 HIV positive patients (123 males and 207 females). A designed questionnaire was used as a diagnostic instrument. Results. The prevalence of TB HIV was found to be 33.9%. It was found to be commoner in females, commonest in the age group 30–39 years. Pulmonary TB was the commonest type of TB found (78.6%). This was followed by TB adenitis (12.5%). The incidence of extrapulmonary TB was 21.4%. There was a high incidence of atypical chest X-ray features and high frequency of negative sputum smears. Conclusions. The overall prevalence rate of TB in HIV (33.9%), and the extrapulmonary presentation of TB are high. Some investigation results were found to be atypical in those with both infections. Physicians should be aware of this pattern of presentation and the atypical findings on investigation for early diagnosis and treatment.
Intrathoracic tumours in patients with Von Recklinghausen's disease have been widely reported, but there are very few cases of reported intrathoracic giant benign neurofibroma with marked mediastinal shift and superior vena cava syndrome. Patients that present with this pathology should be adequately investigated. Surgical resection has been considered curative.
Objective. To assess the radiographic features in patients with Human Immunodeficiency Virus (HIV) complicated by pulmonary tuberculosis (PTB), and the association with CD4 lymphocyte count and sputum smear. Method. A prospective study was carried out on 89 HIV positive patients with PTB. The demographics, smoking history, sputum smear result, chest radiographic findings and CD4 lymphocyte count were documented. Results. Out of the 89 patients recruited in the study, 41 were males and 48 were females. Eighteen (18) patients had typical radiographic features, 60 patients had atypical radiographic features while only 11 of them had normal radiographic films. Sixty eight (68) patients had CD4 count <200 cells/mm3, 19 patients had CD4 count between 200–499 cells/mm3, while only 2 patients had CD4 count from 500 cells/mm3 upwards. The association between low CD4 count and radiographic finding was statistically significant, (P value <0.05). Sixty (60) patients had negative sputum smear for Acid and Alcohol Fast Bacilli (AAFB), while the remaining 29 patients had positive smear. The association between low CD4 count and negative smear was statistically significant (P value <0.05). Conclusion. The radiographic pattern and the result of the sputum smear for AAFB has a significant relationship and association with the immune status of patients with Human Immunodeficiency Virus (HIV) complicated by pulmonary tuberculosis.
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