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Oscar M.P. Jolobe, HIV status should also be documented in patients with tuberculosis-associated symmetrical peripheral gangrene, QJM: An International Journal of Medicine, Volume 105, Issue 7, July 2012, Page 717, https://doi.org/10.1093/qjmed/hcs054
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Sir,
A major difference between the reporting of tuberculosis-associated ‘simultaneous quadrilateral gangrene’ in the era antedating awareness of the association of tuberculosis and human immune deficiency virus (HIV) infection,1 and the reporting of tuberculosis-associated symmetrical peripheral gangrene in the modern era2 is that, in the latter context, evaluation of the patient also ought to encompass documentation of HIV status,2 given the fact that, in its own right, HIV infection may be complicated by large, medium and/or small-sized vasculitis,3 and also by gangrene.3,4 Digital gangrene was, for example, reported in a patient with HIV-associated polyarteritis nodosa (PAN),3 and in three other HIV-infected patients with unspecified PAN status.4 Accordingly, it is hoped that in the patient reported by the authors, the implementation of the strategy of management of the underlying causes of symmetrical peripheral gangrene5 included evaluation of HIV status, as was the case in a comparable patient, reported in 1986, who in the event, tested negative for HIV co-infection.2
