Malabsorption of Antituberculosis Medications by a Patient with AIDS

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Abstract
A male health care worker from New York City who is positive for HIV was recently referred to our facility for management of suspected drug-resistant Mycobacterium tuberculosis disease. 1 Disseminated tuberculosis had been diagnosed presumptively in May 1991 on the basis of a febrile, wasting, lymphadenopathy associated with a positive acid-fast smear of an axillary-lymph-node biopsy specimen. Unfortunately, cultures of the specimen were negative. The patient received isoniazid, rifampin, pyrazinamide, and ethambutol from May 1991 to April 1992, with defervescence and weight gain. In April 1992, however, fevers, lymphadenopathy, and weight loss developed. The patient underwent biopsy of a supraclavicular node; the specimen was subsequently positive for M. tuberculosis on smear and culture.

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