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CASE REPORT Table of Contents   
Year : 2009  |  Volume : 2  |  Issue : 2  |  Page : 63-64
Mixed infections of leg, inguinal ulcer and cellulites in HIV patient


1 Eko CT & MRI Scan Centre, At Medical College and Hospitals Campus, 88-College Street, Kolkata-700 073, India
2 Neurology Department, Medical College and Hospitals, Kolkata, India
3 School of Tropical Medicine, Kolkata, India
4 PG Student, Medicine Department, Kolkata, India

Click here for correspondence address and email

Date of Web Publication10-Jun-2010
 

   Abstract 

Human retrovirus leads to deficiency in the immune system of our body and the body is prone to multiple infections. We present the case of leg ulcer and subsequent development of inguinal ulcer with mixed infections in an immunodeficient patient. The diagnosis was confirmed by serological and bacteriological examination.

Keywords: Human immunodeficiency virus , tuberculosis

How to cite this article:
Hashmi M A, Sharma S K, Guha G, Sengupta P, Saha B, Singhania P. Mixed infections of leg, inguinal ulcer and cellulites in HIV patient. Ann Trop Med Public Health 2009;2:63-4

How to cite this URL:
Hashmi M A, Sharma S K, Guha G, Sengupta P, Saha B, Singhania P. Mixed infections of leg, inguinal ulcer and cellulites in HIV patient. Ann Trop Med Public Health [serial online] 2009 [cited 2018 May 22];2:63-4. Available from: http://www.atmph.org/text.asp?2009/2/2/63/64279

   Introduction Top


Multiple infections are common in immunodeficient patients. Common opportunistic infections, for which normal human beings are not susceptible, quite easily infect a human immunodeficiency virus (HIV) infected patient. Tuberculosis is the commonest infection, which may be focal, disseminated or subcutaneous. Such persons are also prone to multiple bacterial and fungal infections.


   Case Report Top


This is the case of a 27-year-old male patient with fever for 10 months. Fever was not associated with chill and rigor. He had a small road trauma three months ago, which led to abscess over left calf, cellulites and ulceration recently [Figure 1]. He also developed an inguinal lump two months ago, which became tender and ulcerated with multiple pus points in it [Figure 2]. The patient did not have cough or diarrhea. Past medical history revealed that the patient had developed a splenic abscess in April 2005. He had taken a full course of anti tubercular medicine for lung tuberculosis in 2003; had a history of exposures and was tested sero positive for HIV in February 2007.

The patient was cooperative, conscious and average built. He was severely anemic but with normal pulse and blood pressure. Ultrasound examination showed a few para aortic retroperitoneal lymphadenopathies. His CD 4 count was 126 cells /mm, leg ulcer swab study showed acid fast bacilli and Staph aureus [Figure 3]. His lymphnode biopsy showed a few granulomatous cells with acid-fast bacilli.

The patient was put on antibiotics, antitubercular medicines and drugs for immunodeficiency syndrome. The left ulcer showed significant improvement after 10 days of therapy [Figure 4].


   Discussion Top


Infection in HIV is atypical and of mixed type. HIV promotes the progress from latent tubercular infection to active disease and tuberculosis is the leading cause of death in people suffering from HIV. [1] The course of HIV disease spans a period of 15-20 years and the patient needs a holistic approach in its management and care.[2] The possibility of dermotomyositis, an autoimmune disease, has also been cited in HIV positive patients. [3] As the AIDS epidemic has grown; several skin diseases have an increased prevalence. [4] Tuberculosis is the most common opportunistic infection in HIV patients. [5] As CD4 count decreases, the patient is much more prone to multiple infections and the load of virus is increased in blood. [6] HIV has become a challenging task for all doctors treating it, [7] as it is prone to multiple infections. Advanced tuberculosis, disseminated tuberculosis and tubercular skin infections with mixed other infections are common clinical manifestations in HIV patients; [8] and management and proper care are needed in treating such patients.

 
   References Top

1.Elston JW, Thaker HK. Co-infection with human immunodeficiency virus and tuberculosis. ndian J Dermatol Venereol Leprol 2008;74:194-9.  Back to cited text no. 1      
2.Mukherjee S. Advances in management of HIV infection. Indian J Dermatol 2005;50:113-8.  Back to cited text no. 2      
3.Marfatia YS, Ghiya RA, Chaudhary D. Dermatomyositis in a human immunodeficiency virus infected person. Indian J Dermatol Venereol Leprol 2008;74:241-3.  Back to cited text no. 3  [PUBMED]  Medknow Journal  
4.Kar HK, Narayan R, Gautam RK, Jain RK Mucocutaneous disorders in Hiv positive patients. Indian J Dermatol Venereol Leprol 1996;62:283-5.   Back to cited text no. 4      
5.Maniar JK, Kamath RR, Mandalia S, Shah K, Maniar A. HIV and tuberculosis: Partners in crime. Indian J Dermatol Venereol Leprol 2006;72:276-82.  Back to cited text no. 5  [PUBMED]  Medknow Journal  
6.Kannangai R, Kandathil AJ, Ebenezer DL, Nithyanandam G, Samuel P, Abraham OC, et al. Evidence for lower CD4 + T cell and higher viral load in asymptomatic HIV-1 infected individuals of India: Implications for therapy initiation. Indian J Med Microbiol 2008;26:217-21.  Back to cited text no. 6  [PUBMED]  Medknow Journal  
7.Maniar JK. Guest editor. Indian J Dermatol Venereol Leprol 2008;74:193.  Back to cited text no. 7  [PUBMED]  Medknow Journal  
8.Rajasekaran S, Mahilmaran A, Annadurai S, Kumar S. Manifestation of tuberculosis in patients with human immunodeficiency virus: A large Indian study. Ann Thorac Med 2007;2:58-60.  Back to cited text no. 8  [PUBMED]  Medknow Journal  

Top
Correspondence Address:
M A Hashmi
MRI-Section, Eko Ct & Mri Scan Centre, At Medical College and Hospitals Campus, 88-College st., Kolkata- 700 073
India
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Source of Support: None, Conflict of Interest: None


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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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