HIV

Sexual Transmission
Gastrointestinal Tuberculosis

PATHOGENESIS
PRECIPITATING FACTORS
PREDISPOSING FACTORS
 Lifestyle: Alcoholic drinker
 Age  Environment
1. Selective Tropism for CD4
 Immunocompromised
molecule receptor
 Systemic Infection: HIV/AIDS

2. Internalization
Ingestion of sputum (lymphatic
drainage) hematogenous or
3. Uncoating & viral DNA adjacent organs
formation

Tubercle bacilli enters the

4. Viral Integration intestinal tract

5. Viral replication
GI macrophages phagocytosize the bacilli

6. Latent period and immune attack

Formation of phagosome inside the macrophage

7. CD4+ T cell destruction

Susceptibility of the patient to T-bacilli produce proteins that inhibit the fusion
8. Viral dissemination various infections producing from the lysosome to avoid the hydrolytic acid
certain complications produce by the lysosomal organelles

 Hematology result (1/25/18):  Hem Result (1/23/2018):

↓ CD4 count = 37 cell/uL TB proliferates and creates a localized infection ↓WBC = 3.8 x 10^12 g/L
 Hem Result (1/23/2018):  Low grade fever
↓WBC = 3.8 x 10^12 g/L
↓Hgb = 90 g/L
↓Hct = 6.28 g/L After 2-4 weeks, cell-mediated immunity is activated
↓RBC = 3.22 x 10^12/L

Immune cells surround the infection


Ghon focus: granuloma created to wall off bacteria

Tissue inside the granuloma dies  Co-trimaxazole

 Bacteriology Result (01/26/2018):  Metronidazole
Acid Fast Bacilli Smear Result =  Ceftriaxone
Positive for acid fast bacilli  Azithromycin
Spread of infection to the
Caseous necrosis in the GI tract specifically the mesenteries  HRZE
neighboring lymph nodes
Omeprazole  Abdominal pain Tramadol

Alters in the function of the intestinal tract to absorb H2O
Ultrasound Impression:
 Abdomen (1/25/2018):  Less appetite
Mesenteric lymphadenitis at the
paraaortic area  Fecalysis Result (1/25/2018): Hyoscine
 Neck (1/23/2018): Color = Yellowish-brown Butylbromide  Weight loss: Vit. B Complex
Cervical lymphadenopathies Consistecy = loose From 68 kg to
(Scrofula), bilateral  LBM x 4-6 eps 57 kg
 Pain in defecation
 Pallor & weakness