Successful Treatment of Disseminated Bacillus Calmette-Guérin Disease in an HIV-Infected Child with a Linezolid-Containing Regimen

Figure 1

Major events, CD4 cell count and viral load measurements, antiretroviral therapy, and antimycobacterial therapy during the course of the disease. (a) Pneumocystis jiroveci pneumonia; culture of tracheal aspirate M. bovis positive; liver failure, antituberculosis therapy stopped; QuantiFERON TB test negative; ART started. (b) Hypoechogenic splenic lesions seen on ultrasound. (c) Necrotic lymph nodes seen on ultrasound; urticarial rash, after isoniazid reintroduction. (d) Disseminated skin lesions (M. bovis cultured); QuantiFERON TB test positive; blood culture for M. bovis negative; cystic bone lesions. (e) Lopinavir/ritonavir replaced by nevirapine for 2 weeks. (f) Tibial bone biopsy culture for M. bovis positive. (g) Leg abscess culture for M. bovis positive. (h) Skin lesion and lymph node culture for M. bovis negative. (i) Antimycobacterial therapy stopped. VL, viral load (HIV-1 RNA); ART, antiretroviral therapy; ZDV, zidovudine; 3TC, lamivudine; LOPr, lopinavir/ritonavir; ABC, abacavir; RAL, raltegravir; 3/w, three times weekly; TB, tuberculosis.