An Interesting Case of Dysphagia
in a HIV Patient
Published: March 1, 2013 | DOI: https://doi.org/10.7860/JCDR/2013/.2815
Deepak Madi, Basavaprabhu Achappa, John T. Ramapuram, Nithyananda Chowta, Soundarya Mahalingam
1. Assistant Professor, Department of General Medicine,
Kasturba Medical College, Mangalore
(affiliated to Manipal University), India.
2. Associate Professor, Department of General Medicine,
Kasturba Medical College, Mangalore
(affiliated to Manipal University), India.
3. Professor and Unit Chief Department of General Medicine,
Kasturba Medical College, Mangalore
(affiliated to Manipal University), India.
4. Additional Professor, Department of General Medicine,
Kasturba Medical College, Mangalore
(affiliated to Manipal University), India.
5. Associate Professor, Department of Paediatrics,
Kasturba Medical College, Mangalore
(affiliated to Manipal University), India.
Correspondence
Dr. Basavaprabhu Achappa,
Associate Professor,
Department of General Medicine,
Kasturba Medical College,(affiliated to Manipal University)
Attavar,Mangalore,575001
Phone: 998017048
E-mail: bachu1504@gmail.com
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.
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