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Previous Volume 360:2456-2464 June 4, 2009 Number 23 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Anne Griffin (Medicine and Pediatrics): A 24-year-old woman with the acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis was admitted to a hospital in South Africa that is affiliated with this hospital, because of progressive cough, dyspnea, and wasting.

A diagnosis of pulmonary tuberculosis was made 7 months earlier, when she presented at another facility with a productive cough, and a sputum specimen was positive for acid-fast bacilli on sputum-smear microscopy. No chest radiograph was obtained. She had no known history of active tuberculosis. The patient was enrolled in a local Directly Observed Treatment (DOTS) program, and antimycobacterial therapy (isoniazid, . . . [Full Text of this Article]

Differential Diagnosis

Abnormal Laboratory-Test Results

Causes of Persistently Positive Sputum Smears

Causes of Worsening Respiratory Disease

Summary

Clinical Diagnosis

Pathological Discussion

Discussion of Management

Causes of Infection with Extensively Drug-Resistant Tuberculosis

Diagnosis of Drug-Resistant Tuberculosis

Management of Drug-Resistant Tuberculosis in a Resource-Limited Setting

Antiretroviral Therapy

Anatomical Diagnosis

Source Information

From the Department of Medicine, Edendale Hospital, Pietermaritzburg, and the Department of Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu–Natal, Durban — both in South Africa (D.W.); the Division of Infectious Diseases (R.M.H.) and the Department of Radiology (S.D.), Massachusetts General Hospital, Boston; and the Departments of Medicine (R.M.H.) and Radiology (S.D.), Harvard Medical School, Boston.

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