An Interesting Case of Dysphagia in a HIV Patient

• Published in: Journal of Clinical and Diagnostic Research
• Main Authors: Deepak Madi, Basavaprabhu Achappa, John T. Ramapuram, Nithyananda Chowta, Soundarya Mahalingam
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2013-03-01
• Subjects: hiv; dysphagia; tuberculosis; oesophageal ulcer; tracheo-oesophageal fistula
• Online Access: https://jcdr.net/articles/PDF/2815/29%20-%204741_PF1(M)_E(C)_F(T)_PF1(M)_PF1(T)_FA(T).pdf

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.