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Surgery for tuberculosis before and after human immunodeficiency virus infection: a tropical perspective
AIM: To review from a tropical perspective the presentation and management of tuberculosis and how it is affected by coexistent human immunodeficiency virus (HIV) infection. METHODS: A 20-year literature review using Medline (National Library of Medicine, Washington, DC, USA) searches of the terms tuberculosis, HIV and acquired immune deficiency syndrome (AIDS) by site, body system and geographical region was undertaken. RESULTS: The dual epidemic of HIV and tuberculosis now afflicts well over 4 million people. In subSaharan Africa 20-50 per cent of patients with pulmonary tuberculosis and 60-90 per cent of those with extrapulmonary tuberculosis are HIV positive. Tuberculosis presents both with generalized systemic symptoms, and with symptoms and signs according to the site of involvement. Specific sites reviewed include lymph nodes, abdomen, bones and joints, pleural and pericardial spaces, and genitourinary system. CONCLUSION: All surgeons need to be aware of the manifestations of tuberculosis at different sites and the effects of HIV infection. HIV-positive patients are more likely to present with systemic illness and multiple sites of involvement, and to respond poorly to major surgery. Surgical management is generally limited to making a diagnosis or treating life-threatening complications.
History
Journal
British journal of surgeryVolume
84Issue
1Pagination
8 - 14Publisher
John Wiley & SonsLocation
Chichester, Eng.Publisher DOI
ISSN
0007-1323Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
1997, Blackwell ScienceUsage metrics
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No categories selectedKeywords
AIDS-Related Opportunistic InfectionsHumansMycobacterium avium-intracellulare InfectionPeritonitis, TuberculousTuberculosisTuberculosis, GastrointestinalTuberculosis, Lymph NodeTuberculosis, OsteoarticularTuberculosis, PleuralTuberculosis, UrogenitalScience & TechnologyLife Sciences & BiomedicineSurgeryLYMPH-NODE TUBERCULOSISGENITOURINARY TUBERCULOSISHIV-INFECTIONABDOMINAL TUBERCULOSISPULMONARY TUBERCULOSISAIDS PATIENTSMYCOBACTERIAL LYMPHADENITISEXTRAPULMONARY TUBERCULOSISHIV-1-INFECTED PATIENTSGASTROINTESTINAL-TRACT
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