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Human immunodeficiency virus in a tribal family: Issues and challenges.

Patel D, Bharti A, Pandya I, Naik E, Marfatia YS - Indian J Sex Transm Dis (2014 Jul-Dec)

Bottom Line: Her husband and son were also found to be HIV positive.Her husband left her for another woman.The purpose of reporting this case is to discuss the issues related to HIV infection affecting all the members of a tribal family.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin-VD, Medical College, Vadodara, Gujarat, India.

ABSTRACT
A 35-year-old married tribal female presented with well-defined crusted ulcers with purulent exudates on the right side of the face involving both lips and right forearm since last 6 months. On investigation, she turned out to be human immunodeficiency virus (HIV) positive with CD4 count of 7 cell/mm(3) and also having probable abdominal tuberculosis (TB) as suggested by ultrasonography abdomen. Her husband and son were also found to be HIV positive. Her skin lesions were suggestive of cutaneous TB. She was started on antituberculosis treatment (ATT), antiretroviral treatment (ART), and injectable antibiotics. As her skin lesions failed to respond after 1 month, herpes simplex virus infection was suspected as a cause of ulceration, and she was given oral acyclovir therapy to which she responded well and later she was discharged. She stopped both ART and ATT and came with recurrence of skin lesions after 1½ month. Her husband left her for another woman. The purpose of reporting this case is to discuss the issues related to HIV infection affecting all the members of a tribal family.

No MeSH data available.


Related in: MedlinePlus

Posttreatment photograph showing healing after oral acyclovir therapy
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Figure 5: Posttreatment photograph showing healing after oral acyclovir therapy

Mentions: The patient was admitted and administered intravenous cefotaxime 1 g every 12 hourly for 10 days to control superadded bacterial infection. Capsule fluconazole was given once daily for 2 weeks for oral candidiasis. Category I antituberculosis treatment (ATT) which included isoniazid (300 mg), rifampicin (450 mg), pyrazinamide (1500 mg), and ethambutol (1200 mg) was started for abdominal TB along with tablet cotrimoxazole (480 mg) once a day. Since the patient was severely anemic, 2 units packed cell volume was given along with injection iron sucrose intravenous for 10 days. Daily ulcer dressing with 1% silver sulfadiazine cream was done. Twenty days later ART was initiated (tenofovir [300 mg]/lamivudine [300 mg]/efavirenz [600 mg]). After 4 weeks of admission, as there was no response of the ulcers on lips and right arm to either of antibiotics or ATT, herpes infection was suspected as a cause of ulceration. Tzank smear was done, which showed multinucleated giant cells and IgM and IgG anti-herpes simplex virus (HSV) I/II were found to be positive. Tablet acyclovir 400 mg 3 times a day was started. Signs of healing were observed within 1 week of initiation of acyclovir and same treatment was continued for 25 days until the lesions healed completely [Figures 4 and 5].


Human immunodeficiency virus in a tribal family: Issues and challenges.

Patel D, Bharti A, Pandya I, Naik E, Marfatia YS - Indian J Sex Transm Dis (2014 Jul-Dec)

Posttreatment photograph showing healing after oral acyclovir therapy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553843&req=5

Figure 5: Posttreatment photograph showing healing after oral acyclovir therapy
Mentions: The patient was admitted and administered intravenous cefotaxime 1 g every 12 hourly for 10 days to control superadded bacterial infection. Capsule fluconazole was given once daily for 2 weeks for oral candidiasis. Category I antituberculosis treatment (ATT) which included isoniazid (300 mg), rifampicin (450 mg), pyrazinamide (1500 mg), and ethambutol (1200 mg) was started for abdominal TB along with tablet cotrimoxazole (480 mg) once a day. Since the patient was severely anemic, 2 units packed cell volume was given along with injection iron sucrose intravenous for 10 days. Daily ulcer dressing with 1% silver sulfadiazine cream was done. Twenty days later ART was initiated (tenofovir [300 mg]/lamivudine [300 mg]/efavirenz [600 mg]). After 4 weeks of admission, as there was no response of the ulcers on lips and right arm to either of antibiotics or ATT, herpes infection was suspected as a cause of ulceration. Tzank smear was done, which showed multinucleated giant cells and IgM and IgG anti-herpes simplex virus (HSV) I/II were found to be positive. Tablet acyclovir 400 mg 3 times a day was started. Signs of healing were observed within 1 week of initiation of acyclovir and same treatment was continued for 25 days until the lesions healed completely [Figures 4 and 5].

Bottom Line: Her husband and son were also found to be HIV positive.Her husband left her for another woman.The purpose of reporting this case is to discuss the issues related to HIV infection affecting all the members of a tribal family.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin-VD, Medical College, Vadodara, Gujarat, India.

ABSTRACT
A 35-year-old married tribal female presented with well-defined crusted ulcers with purulent exudates on the right side of the face involving both lips and right forearm since last 6 months. On investigation, she turned out to be human immunodeficiency virus (HIV) positive with CD4 count of 7 cell/mm(3) and also having probable abdominal tuberculosis (TB) as suggested by ultrasonography abdomen. Her husband and son were also found to be HIV positive. Her skin lesions were suggestive of cutaneous TB. She was started on antituberculosis treatment (ATT), antiretroviral treatment (ART), and injectable antibiotics. As her skin lesions failed to respond after 1 month, herpes simplex virus infection was suspected as a cause of ulceration, and she was given oral acyclovir therapy to which she responded well and later she was discharged. She stopped both ART and ATT and came with recurrence of skin lesions after 1½ month. Her husband left her for another woman. The purpose of reporting this case is to discuss the issues related to HIV infection affecting all the members of a tribal family.

No MeSH data available.


Related in: MedlinePlus