1/66. Hormonal and immunological pattern in a patient with acquired immunodeficiency syndrome related complex and Cushing's syndrome.A case of Cushing's syndrome in a 24-yr-old homosexual with an aids-related complex is reported. In this patient certain symptoms common to both diseases, i.e. weakness, myalgia and muscle atrophy were accentuated, whereas other symptoms pathognomic of the human immunodeficiency virus (HIV) infection, i.e. lymphoadenopathies and weight loss, were less pronounced by the high levels of circulating adrenal steroids. ketoconazole was administered po in order to block adrenal steroidogenesis, the drug caused a remarkable fall of cortisol serum concentrations, but was unable to modify significantly the immunological pattern of the patient. Our data suggest that changes of serum adrenal steroid levels have little effect on the immune network of patients with AIDS.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/66. Unusual skin pigmentation in a patient with human immunodeficiency virus (HIV) infection.Diffuse addisonian hyperpigmentation in a male patient with acquired immunodeficiency syndrome related complex (ARC) is described. The etiology of pigmentation in this patient remains obscure but is most probably related to the H.I.V. infection. Other causes of addisonian hyperpigmentation are considered less likely.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
3/66. aids-related complex treated by antiviral drugs and allogeneic bone marrow transplantation following conditioning protocol with busulphan, cyclophosphamide and cyclosporin.A 26-year-old man with aids-related complex (ARC) was treated with high-dose busulphan and cyclophosphamide, followed by allogeneic bone marrow transplantation. For 3 months before transplantation he received a combination of four drugs considered active against human immunodeficiency virus (HIV) to reduce the viral burden: zidovudine, acyloguanosine, fusidic acid and phenylidantoin. Although in reduced doses in coincidence with marrow engraftment, zidovudine therapy was scheduled after transplantation in order to protect donor cells from infection with HIV. Engraftment rapidly occurred and was documented by cytogenetic analyses. The post-transplant course was characterized by severe acute GvHD with irreversible hepatorenal failure. The patient died on day 48 after transplantation. polymerase chain reaction analyses for detecting HIV dna showed the persistence of positivity at day 30 and 45 after transplantation. Antibodies to specific HIV proteins evaluated with Western blot testing also persisted at days 21 and 35 after transplantation. Circulating immunocomplexes disappeared on day 31, and an increase in the CD4/CD8 ratio occurred. The short survival of the patient, affected by chronic hepatitis too, does not allow final conclusions about the role of BMT in HIV disease.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/66. Toxic epidermal necrolysis due to vancomycin.Toxic epidermal necrolysis due to vancomycin is reported in a patient with human immunodeficiency virus infection. The same patient had anaphylaxis to cloxacillin but tolerated other penicillin derivatives. These reactions were documented using in vivo and in vitro tests. The role of human immunodeficiency virus infection in the pathogenesis of these reactions is discussed.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
5/66. Pyrexia of unknown origin and HIV infection in a middle aged woman. A case study.Pyrexia of unknown origin (PUO) is defined as a prolonged fever of more than 3 weeks duration and which resists a diagnosis after a week in hospital. Here we present a case admitted in our hospital with fever of prolonged duration, esophageal candidiasis, multiple systemic symptoms and infections. She was diagnosed as being infected by HIV and presenting with AIDS related complex with no clear details of the source of infection. There is no significant history of exposure, sexual transmission or blood transfusions. The only mode suggestive of acquiring HIV in this case was probably due to her repeated hospital admissions and repeated intravenous infusions. She also had history of dental procedures which may be a considerable factor.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
6/66. Anti-neutrophil cytoplasmic autoantibodies in patients with symptomatic HIV infection.Antibodies against cytoplasmic antigens of neutrophils, producing perinuclear (p-ANCA) as well as cytoplasmic staining with central accentuation (c-ANCA), have been described in non-HIV-infected patients with specific pathology such as glomerulonephritis and vasculitis. Here, we report on a patient with a vasculitis-like syndrome and a positive ANCA-test who appeared to be infected by HIV. Further analysis revealed that ANCA, p-ANCA as well as c-ANCA without central accentuation can be demonstrated in the serum of HIV individuals. In a cross-sectional study on individuals in different stages of HIV infection, we found that the occurrence of ANCA was limited to the symptomatic stages of HIV infection: p-ANCA was found in one out of 10 ARC patients and in two out of 11 AIDS patients with malignancies (AIDS-MAL), but not in AIDS patients with opportunistic infections (AIDS-OI). c-ANCA was found in four of the ARC patients, in two of the 14 AIDS-OI patients and in two AIDS-MAL patients. The presence of ANCA was not related to the degree of hypergammaglobulinaemia nor to specific symptomatology. ANCA containing sera from HIV individuals did not react with HEp2 cells nor with cytoplasmic antigens of lymphocytes, natural killer (NK) cells or eosinophils. Five out of the 11 (two p-ANCA and three c-ANCA) sera reacted weakly with cytoplasmic antigens of monocytes. All sera reacted with karyoplasts but not with cytoplasts prepared from neutrophils. These results suggest that HIV-ANCA might be directed against myeloid cell-specific granule constituents. However, sandwich-ELISAs with MoAbs against granule antigens that are frequently the target antigens of ANCA in HIV- individuals were negative. Also immunoprecipitation and immunoblotting, using lysates of neutrophil granules, did not allow further identification of the target antigens of HIV-ANCA.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
7/66. Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient.A 40-year-old, HIV-infected female patient received antibiotic treatment for a urinary tract infection. After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). In spite of intensive care and respirator therapy with positive end-expiratory pressure (PEEP), she died of infectious toxic shock. autopsy findings showed relapsing, gram-negative, bacterial pneumonia (morphologically compatible with klebsiella pneumonia) and secondary, invasive aspergillosis. The pathogenesis and epidemiology of these unusual complications of AIDS are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/66. epidermodysplasia verruciformis-associated papillomavirus infection complicating human immunodeficiency virus disease.Three males infected with the human immunodeficiency virus (HIV) were noted to have extensive flat warts of the face and/or body. In two there were also pityriasis versicolor-like lesions. Biopsies showed foamy, basophilic, distended cytoplasm in granular layer keratinocytes, characteristic of the human papillomavirus types seen in epidermodysplasia verruciformis. dna hybridization techniques demonstrated the presence of HPV-type 8 in one patient and HPV 5 and 8 in another. patients with immune suppression due to HIV infection may demonstrate the clinical features of epidermodysplasia verruciformis with the same potentially oncogenic HPV types.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
9/66. Effects of glycyrrhizin (SNMC: Stronger Neo-Minophagen C) in hemophilia patients with hiv-1 infection.Forty-two hemophiliacs with HIV infection were treated with high-dose glycyrrhizin, Stronger Neo-Minophagen C (SNMC). The dose was 100-200 ml of SNMC in 21 patients and 400-800 ml in the other 21. The patients were divided into an asymptomatic carrier (AC) group and AIDS related-complex (ARC)/AIDS group. SNMC was administered intravenously daily for the first 3 weeks, and every second day for the following 8 weeks to the 42 HIV-infected hemophilia patients, in accordance with the protocol proposed by the Japanese National research Committee. The CD4/CD8 ratio and CD4 positive lymphocyte counts did not change during the treatment period. However, significant improvement was noted in some cases. A slight increase in mitogenic responsiveness to phytohemagglutinin, concanavalin a and pokeweed mitogen was noted in most patients of both groups, especially significant improvement was seen in the AC group administered over 400 ml of SNMC. Furthermore, complete improvement was noted in liver dysfunction, which has been thought to be one of the major problems for hemophiliacs treated with blood products. Thus, prophylactic administration of high-dose SNMC to HIV positive hemophiliacs who have impaired immunological ability and liver dysfunction was considered to be effective in preventing the development from AC/ARC to AIDS.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
10/66. cytomegalovirus encephalopathy in an infant with congenital acquired immuno-deficiency syndrome.A female infant born pre-term to a HIV seropositive mother presented at birth with seropositivity for HIV and CMV viruria. At five months of age she developed an aids-related complex. Six months later she died from rapidly progressive diffuse encephalopathy. Post mortem examination revealed generalized CMV infection. Neuropathological examination showed a nodular encephalitis with occasional cytomegalic cells containing characteristic CMV inclusion bodies. There was no evidence of HIV encephalitis; immunostaining for HIV antigen (gp 41) was negative. opportunistic infections in infants with congenital AIDS are the exception. To our knowledge, only one case of CMV encephalitis in an infant with congenital AIDS has been reported previously. In that case, as in the present one, a reactivation of a congenital CMV infection is likely.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
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