Adenotonsillar hypertrophy and otitis media with effusion as an initial presentation of HIV in an adult male (a case report)

Abstract Background Adeno-tonsillar hyperplasia together with otitis media with effusion (OME) in adults should prompt careful evaluation, as it may reflect an underlying malignant or systemic condition, including lymphoma, carcinoma, or HIV infection. Case report Herein, we present a case of a 50-year-old male whose initial presentation of HIV infection was adenotonsillar hypertrophy and otitis media with effusion. The patient exhibited substantial clinical improvement after 6 months of antiretroviral therapy (ART), with a significant reduction in the size of the nasopharyngeal, palatine, and lingual tonsils. Conclusion Adeno-tonsillar hypertrophy could be an initial manifestation of HIV infection, particularly in patients with lower CD4 levels and higher viral loads. Recognition of this association is crucial for timely diagnosis and management. These manifestations can significantly improve with the use of ART. Further studies with a large cohort of patients addressing adenotonsillar hyperplasia in HIV patients are recommended.