CD4+ T-lymphocytopenia and Pneumocystis carinii pneumonia in a patient with miliary tuberculosis

Onorati, Paolo; Carfagna, Paolo; Palange, Paolo; Venditti, Mario; Serra, Pietro

doi:10.1016/s0953-6205(01)00113-3

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…4 Previous studies have described the association between tuberculosis and CD4þ T lymphocytopenia, especially that in HIV infections; however, it remains unclear whether the low count is a result of tuberculosis or a predisposing factor in non-HIV-infected patients. 3,5 By contrast, in our case, it is likely that the coexistence of CD4þ T lymphocytopenia and malnutrition affected our patient's immune system. Thus, the low CD4þ T cell count facilitated the development of an opportunistic P. jiroveci infection.…”

Section: Dear Editorcontrasting

confidence: 62%

Coinfection of Pneumocystis jiroveci pneumonia and pulmonary tuberculosis in a non-HIV-infected patient

Suk

Bai

et al. 2015

Journal of Microbiology, Immunology and Infection

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Section: Dear Editorcontrasting

confidence: 62%

Coinfection of Pneumocystis jiroveci pneumonia and pulmonary tuberculosis in a non-HIV-infected patient

Suk

Bai

et al. 2015

Journal of Microbiology, Immunology and Infection

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“…It has been demonstrated that patients with TB with initial lymphocytopenia (a situation similar to that of transplanted patients) show an initial decrease in all lymphocyte populations, a situation that is reverted after effective treatment (22). Patients with TB and non‐selective CD4 lymphocytopenia at diagnosis have been shown to normalize CD4 count after treatment for TB, suggesting that TB itself was causing non‐selective CD4 lymphocytopenia (20, 23, 24). The occurrence of PCP in a previously healthy patient in the setting of miliary TB and acquired CD4+ lymphocytopenia (24) and the occurrence of 39 cases of dual infections caused by P. carinii and M. tuberculosis in HIV‐positive patients have been reported (25).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with TB and non‐selective CD4 lymphocytopenia at diagnosis have been shown to normalize CD4 count after treatment for TB, suggesting that TB itself was causing non‐selective CD4 lymphocytopenia (20, 23, 24). The occurrence of PCP in a previously healthy patient in the setting of miliary TB and acquired CD4+ lymphocytopenia (24) and the occurrence of 39 cases of dual infections caused by P. carinii and M. tuberculosis in HIV‐positive patients have been reported (25). The authors report that 10 patients treated for TB who received no treatment for PCP improved and were discharged from hospital (25).…”

Section: Discussionmentioning

confidence: 99%

“…show an initial decrease in all lymphocyte populations, a situation that is reverted after e¡ective treatment (22). Patients with TB and non-selective CD4 lymphocytopenia at diagnosis have been shown to normalize CD4 count after treatment for TB, suggesting that TB itself was causing non-selective CD4 lymphocytopenia (20,23,24). The occurrence of PCP in a previously healthy patient in the setting of miliaryTB and acquired CD41 lymphocytopenia (24) Serologic evidence of hepatitis C infection was more frequent in cases than in controls.…”

Section: Anti-rejection Treatments In Kidney Transplant Patients Withmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for Pneumocystis carinii pneumonia in kidney transplant recipients: a case–control study

Radisic¹,

Lattes²,

Chapman³

et al. 2003

Transplant Infectious Dis

128

116

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The risk of PCP in kidney transplant recipients is related to the number and type of rejection treatments. It is also related to the occurrence of CMV infection, and to other immunomodulating infections such as TB and hepatitis C, and might also be increased with the use of newer and more potent immunosuppressive agents. Primary prophylaxis failure may occur in association with some of these risk factors.

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“…1 Dissemination of urinary TB after performing lithotripsy is a rare entity and to the best of our knowledge only three cases have been reported previously. 2,3 Herein, the authors report a case of undiagnosed HIV in a patient with urinary TB who presented with disseminated TB after performing extracorporeal shock wave lithotripsy (ESWL).…”

Section: Introductionmentioning

confidence: 99%

Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis

et al. 2013

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Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis.

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CD4+ T-lymphocytopenia and Pneumocystis carinii pneumonia in a patient with miliary tuberculosis

Cited by 8 publications

References 24 publications

Coinfection of Pneumocystis jiroveci pneumonia and pulmonary tuberculosis in a non-HIV-infected patient

Coinfection of Pneumocystis jiroveci pneumonia and pulmonary tuberculosis in a non-HIV-infected patient

Risk factors for Pneumocystis carinii pneumonia in kidney transplant recipients: a case–control study

Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis

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