TUBERCULOUS PANCREATIC-ABSCESS AS AN INITIAL AIDS-DEFINING DISORDER IN A PATIENT INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS - CASE-REPORT AND REVIEW

Tuberculosis (TB) is the most common opportunistic infection worldwide in human immunodeficiency virus (HIV)-infected patients. Intraabdomin al TB includes lymphadenopathy and focal lesions of solid viscera. Sym ptomatic expression of tuberculous invasion of the pancreas (supplemen ted by demonstration of a mass on imaging) is rare among HIV-infected patients, We report the case of an HIV-infected patient with a tubercu lous pancreatic abscess and review nine similar cases. All patients pr esented with persistent fever and abdominal pain. The diagnosis was ma de on the basis of detection of pancreatic mass lesions on computed to mographic (CT) scans and the results of cultures and/or acid-fast stai ns of peripancreatic abscess material and/or other body fluids. Despit e an excellent response to antituberculous therapy, three patients die d of unrelated causes. In the setting of a febrile illness with abdomi nal symptoms, tuberculous pancreatic abscess should be considered in t he differential diagnosis for HIV-infected patients with a CT-identifi ed mass lesion.