TB, ever present.

In our HIV patients we continually need to remember Tuberculosis.  10-15 % of the HIV patients will develop active TB each year.  Because of their immunosuppression they will not always present with classic Tuberculosis symptoms.  Additionally their TB may be non-pulmonary in location.
 
Deborah is a 34 year old lady with HIV who has been in the hospital for over 2 weeks.  She has been spiking fevers of 105 daily.  Despite her fever she continued to smile and claimed to be well except for headache related to fever.  She has been treated for malaria and been given antibiotics for every possible bacterial infection.  Despite this, every night Deborah  continued with spiking fevers.  Last week Dr Eugene started TB medications.  It took 5 days but finally Deborah’s temperature has been normal for 2 days.  She was so happy to be discharged today.