There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Image in medicine
A 39-year-old woman presented with symptoms of dyspnea, orthopnea, paroxysmal nocturnal
dyspnea, weight loss, night sweats and fatigue that were present for 3-months. She
had been diagnosed with human immunodeficiency virus (HIV) infection in 2016 but had
defaulted her antiretroviral therapy. She had a low CD4 count of 17 cells/μl and her
HIV viral load was log 6.16 copies/ml. She had evidence of high-output cardiac failure
on clinical examination that included a wide pulse pressure with a blood pressure
of 138/59 mmHg, radial pulse had a collapsing character and the pulse rate was 125
beats per minute, jugular venous distention was observed, the apical impulse was displaced
with no audible murmurs and bibasilar crackles were present. She had a thrill palpable
over the right femoral artery and a continuous bruit was audible. Significant laboratory
results included a hemoglobin concentration of 6.7 g/dL and an erythrocyte sedimentation
rate of more than 140 mm/hour. Importantly, rapid plasma reagin, anti-nuclear antibodies
and anti-neutrophil cytoplasmic antibodies were negative. Computed tomography angiogram
(CT angiogram) revealed fusiform aneurysmal dilatation of the distal abdominal aorta
and right common iliac artery with multiple right lower limb arteriovenous fistulae
and venous aneurysms. There were no other clinical or radiological findings to suggest
a large-vessel vasculitis such as Takayasu´s arteritis. Mycobacterium tuberculosis
was cultured from multiple sources including a gastric aspirate, blood and sputum
samples. A diagnosis of tuberculous arteritis was made. Anti-tuberculous and heart
failure treatment were commenced and her antiretroviral therapy was reinitiated. She
reported significant improvement of her symptoms. However, 1-week following hospital
discharge, the patient demised.
Figure 1
computed tomography angiogram
Author and article information
Journal
Journal ID (nlm-ta): Pan Afr Med J
Journal ID (iso-abbrev): Pan Afr Med J
Journal ID (publisher-id): PAMJ
Title:
The Pan African Medical Journal
Publisher:
The African Field Epidemiology Network
ISSN
(Electronic):
1937-8688
Publication date
(Electronic):
18
November
2020
Publication date Collection: 2020
Volume: 37
Electronic Location Identifier: 246
Affiliations
[1
]Division of General Medicine, Department of Medicine, Faculty of Medicine and Health
Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
Author notes
Corresponding author: Mogamat-Yazied Chothia, Division of General Medicine, Department of Medicine, Faculty
of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape
Town, South Africa.
yaziedc@
123456sun.ac.za
The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article
distributed under the terms of the Creative Commons Attribution International 4.0
License (
https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.