HIV, tuberculose e doença inflamatória intestinal: diagnósticos diferenciais com base em relato de caso

Abstract

Inflammatory bowel diseases (IBD) have a multifactorial etiology. The association between IBD and HIV infection, which is not very prevalent, is a diagnostic and therapeutic challenge. This study was approved by the Ethics Committee of its institution and presents the case report of a young patient with AIDS (acquired immunodeficiency syndrome) and a history of previous tuberculosis, who developed acute abdomen and underwent multiple surgeries due to infectious complications, developing enterocutaneous fistulas. He was ultimately referred for right ileocolectomy. The absence of specific microbiological findings, clinical response to empirical treatment with RHZE (rifampicin, isoniazid, pyrazinamide and ethambutol) and anatomopathological findings of the surgical specimen suggestive or conclusive of intestinal tuberculosis reinforce the hypothesis of penetrating Crohn's disease (CD). The therapeutic strategy was similar to the one of patients without HIV, prioritizing the level of medication safety for opportunistic infections.