Skip to main content

Advertisement

SpringerLink
Log in

Peliosis hepatis due to disseminated tuberculosis in a patient with AIDS

  • Case Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Peliosis hepatis is a rare histopathological entity of unknown etiology. We present a case of peliosis hepatis in a 44-year-old man with disseminated tuberculosis and acquired immunodeficiency syndrome. The diagnosis of peliosis hepatis was based on liver biopsy results which were suggestive of tuberculous etiology. Diagnosis of tuberculosis was confirmed by auramine stain, rRNA amplification and culture of Mycobacterium tuberculosis from synovial fluid of the elbow joint. The patient responded favourably to tuberculostatic treatment with four drugs and the early initiation of highly active antiretroviral therapy. Histopathological evidence of peliosis hepatis, without an obvious cause, makes it necessary to rule out tuberculosis, especially in the context of immunodeficiency diseases and immigrants from endemic areas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Miralles P, Moreno S, Pérez-Tascón M, Cosín J, Díaz MD, Bouza E. Fever of uncertain origin in patients infected with the human immunodeficiency virus. Clin Infect Dis. 1995;20:872–5.

    Article  CAS  PubMed  Google Scholar 

  2. Sharma SK, Mohan A, Sharma A, Mitra DK. Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis. 2005;5:415–30.

    Article  CAS  PubMed  Google Scholar 

  3. Maartens G, Willcox PA, Benatar SR. Miliary tuberculosis: rapid diagnosis, hematologic abnormalities and outcome in 109 treated adults. Am J Med. 1990;89:291–6.

    Article  CAS  PubMed  Google Scholar 

  4. Lange CG, Getty PJ, Morrissey AB, George AL, Young PC, Armitage KG. Destructive osteoarthritis after delayed diagnosis of tuberculosis. Infection. 2002;30:46–9.

    Article  CAS  PubMed  Google Scholar 

  5. Marschall J, Evison JM, Droz S, Studer UC, Zimmerli S. Disseminated tuberculosis following total knee arthroplasty in an HIV patient. Infection. 2008;36:274–8.

    Article  CAS  PubMed  Google Scholar 

  6. Foocharoen C, Nanagara R, Foocharoen T, Mootsikapun P, Suwannaroj S, Mahakkanukrauh A. Clinical features of tuberculous septic arthritis in Khon Kaen, Thailand: a 10-year retrospective study. Southeast Asian J Trop Med Public Health. 2010;41:1438–46.

    PubMed  Google Scholar 

  7. Miller RF, Hingorami AD, Foley NM. Pyrexia of undetermined origin in patients with human immunodeficiency virus infection and AIDS. Int J STD AIDS. 1996;7:170–5.

    Article  CAS  PubMed  Google Scholar 

  8. Zak FG. Peliosis hepatis. Am J Pathol. 1950;26:1–15.

    CAS  PubMed  Google Scholar 

  9. Wagner E. Fall von blutcysten der leber. Arch d Heilk. 1861;2:369–70.

    Google Scholar 

  10. Atila K, Coker A, Uçar D, Karademir S, Sagôl O, Astarcioglu H, et al. A rare clinical entity misdiagnosed as a tumor: peliosis hepatis. Ulus Travma Acil Cerrahi Derg. 2007;13:149–53.

    PubMed  Google Scholar 

  11. Zafrani ES, Cazier A, Baudelot AM, Feldman G. Ultrastructural lesions of the liver in human peliosis. A report of 12 cases. Am J Pathol. 1984;114:349–59.

    CAS  PubMed  Google Scholar 

  12. Leong SS, Cazen RA, Yu GS, LeFevre L, Carson JW. Abdominal visceral peliosis associated with bacillary angiomatosis. Ultrastructural evidence of endothelial destruction by bacilli. Arch Pathol Lab Med. 1992;116:866–71.

    CAS  PubMed  Google Scholar 

  13. Tsokos M, Erbersdobler A. Pathology of peliosis. Forensic Sci Int. 2005;149:25–33.

    Article  PubMed  Google Scholar 

  14. Kempf VA, Volkmann B, Schaller M, Sander CA, Alitalo K, Riess T, et al. Evidence of a leading role for VEGF in Bartonella henselae-induced endothelial cell proliferations. Cell Microbiol. 2001;3:623–32.

    Article  CAS  PubMed  Google Scholar 

  15. Czapar CA, Weldon-Linne CM, Moore DM, Rhone DP. Peliosis hepatis in the acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1986;110:611–3.

    CAS  PubMed  Google Scholar 

  16. Scoazec JY, Marche C, Girard PM, Houtmann J, Durand-Schneider AM, Saimot AG, et al. Peliosis hepatis and sinusoidal dilatation during infection by the human immunodeficiency virus (HIV). An ultrastructural study. Am J Pathol. 1988;131:38–47.

    CAS  PubMed  Google Scholar 

  17. Perkocha LA, Geaghan SM, Yen TS, Nishimura SL, Chan SP, Garcia-Kennedy R, et al. Clinical and pathological features of bacillary peliosis hepatis in association with human immunodeficiency virus infection. N Engl J Med. 1990;323:1581–6.

    Article  CAS  PubMed  Google Scholar 

  18. Sandrasegaran K, Hawes DR, Matthew G. Hepatic peliosis (bacillary angiomatosis) in AIDS: CT findings. Abdom Imaging. 2005;30:738–40.

    Article  CAS  PubMed  Google Scholar 

  19. Iannaccone R, Federle MP, Brancatelli G, Matsui O, Fishman EK, Narra VR, et al. Peliosis hepatis: spectrum of imaging findings. AJR Am J Roentgenol. 2006;187:W43–52.

    Article  PubMed  Google Scholar 

  20. Wong AK, Alfert M, Catrillon DH, Shen Q, Holash J, Yancopoulos GD, et al. Excessive tumor-elaborated VEGF and its neutralization define a lethal paraneoplastic syndrome. Proc Natl Acad Sci USA. 2001;98:7481–6.

    Article  CAS  PubMed  Google Scholar 

  21. Resto-Ruiz SI, Schmiederer M, Sweger D, Newton C, Klein TW, Friedman H, et al. Induction of a potential paracrine angiogenic loop between human TPH-1 macrophages and human microvascular endothelial cells during Bartonella henselae infection. Infect Immun. 2002;70:4564–70.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Saita N, Fujiwara N, Yano I, Soejima K, Kobayashi K. Trehalose 6,6′-dimycolate (cord factor) of Mycobacterium tuberculosis induces corneal angiogenesis in rats. Infect Immun. 2000;68:5991–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Sakaguchi I, Ikeda N, Nakayama M, Kato Y, Yano I, Kaneda K. Trehalose 6,6′-dimycolate (cord factor) enhances neovascularization through vascular endothelial growth factor production by neutrophils and macrophages. Infect Immun. 2000;68:2043–52.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Microbiology Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, 28034, Madrid, Spain

    L. Sanz-Canalejas, E. Gómez-Mampaso & R. Cantón-Moreno

  2. Pathology Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, 28034, Madrid, Spain

    C. Varona-Crespo

  3. Infectious Diseases Department, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, 28034, Madrid, Spain

    J. Fortún & F. Dronda

Authors
  1. L. Sanz-Canalejas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Gómez-Mampaso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Cantón-Moreno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Varona-Crespo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Fortún
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Dronda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Sanz-Canalejas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sanz-Canalejas, L., Gómez-Mampaso, E., Cantón-Moreno, R. et al. Peliosis hepatis due to disseminated tuberculosis in a patient with AIDS. Infection 42, 185–189 (2014). https://doi.org/10.1007/s15010-013-0490-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-013-0490-3

Keywords

Search

Navigation