Summary
Perforation of the esophagus induced by tuberculosis with no evidence of HIV infection is an extremely unusual presentation of the disease. We report on a 41-year-old man presenting with an esophageal perforation who developed a sepsis syndrome characterized by multiple organ dysfunction. The perforation was covered endoscopically with a tube, the patient recovered from cardiovascular, renal and pulmonary dysfunction under intensive care treatment, including antimycobacterial therapy. In response to endoscopic and medical treatment the size of the lesion decreased and disappeared 56 days after diagnosis. The patient could be discharged 2 months after admission and remained asymptomatic after a 12 month follow-up examination.
Zusammenfassung
Eine durch Tuberkulose bedingte Ösophagusperforation ist eine seltene Komplikation der Tuberkulose. Wir stellen einen 41-jährigen Mann mit einer Perforation im Rahmen einerMycobacterium tuberculosis-Infektion vor, bei dem kein eindeutiger Hinweis auf einen pulmonalen Ursprung vorlag und eine HIV-Infektion ausgeschlossen werden konnte. Dieser Patient entwickelte ein Sepsis-Syndrom, welches durch eine kardiovaskuläre, renale und pulmonale Dysfunktion charakterisiert war. Die Perforation wurde endoskopisch mit einem Tubus überbrückt und der Patient erholte sich unter intensivmedizinischer und antimykobakterieller Therapie. Die Läsion war nach 56 Tagen nicht mehr erkennbar, der Patient konnte 2 Monate nach Aufnahme entlassen werden und ist nach 1 Jahr asymptomatisch geblieben.
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Schröder, J., Vogel, I., Thybusch, A. et al. Sepsis syndrome induced by tuberculous perforation of the esophagus. Infection 24, 162–163 (1996). https://doi.org/10.1007/BF01713329
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DOI: https://doi.org/10.1007/BF01713329