[Internal calls to the emergency team of medical area].
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Biomedical subjects
Publications and source records attributed to C Mínguez.
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Tuberculosis is nowadays an uncommon cause of superior vena cava syndrome (SVCS). We report the case of an HIV-infected patient who presented with respiratory symptoms accompanied by cervical and mediastinal lymphadenopathy. Sputum examination showed acid-fast bacilli, and treatment was instituted with isoniazid, rifampicin, pyrazinamide and ethambutol. A few days later SVCS developed, presumably as a consequence of inflammatory lymphadenitis. With corticosteroids, all symptoms disappeared. To our knowledge, no cases of SVCS provoked by this kind of paradoxical reaction have been described previously.
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53 HIV-positive patients, 66% of them zidovudine-experienced, were randomized to receive monotherapy with zidovudine or sequential therapy with zidovudine, didanosine and zalcitabine. Clinical end points, CD4 cell count change, and analysis abnormalities showed better results with sequential therapy.
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