1/11. Unusual etiology of visual loss in an hiv-infected patient due to endogenous endophthalmitis.Disseminated candidiasis, especially ocular infections such as endophthalmitis, is uncommon in hiv-infected patients. We report a case of candidal endophthalmitis in an hiv-positive non-drug-user patient, following candidemia from a cutaneous abscess at the site of a peripheral catheter. Ocular disease was revealed by a visual decrease in the left eye. dna analysis using RAPD showed identical patterns of candida albicans isolated from the skin and eye. Combination therapy with high-dose fluconazole and intravenous amphotericin b was performed. Two intravitreal amphotericin b injections and a vitrectomy were administered because of an amblyopic right eye and severe vitritis. The outcome was favorable without relapse at 18 months.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
2/11. Symptomatic anterior uveitis in hiv-positive patients.Symptomatic anterior uveitis is rare in hiv-positive patients. The uveitis associated with cytomegalovirus retinitis (CMVR), the commonest ocular manifestation in AIDS patients, is rarely symptomatic and patients do not typically present with a red painful eye in conjunction with blurred vision. In this article we report 12 cases of symptomatic anterior uveitis in hiv-positive patients and discuss the aetiology. The case notes of all hiv-positive patients presenting to the eye department with symptoms of uveitis over a 4-year period were studied retrospectively. The notes were analysed for age, sex, race, risk factors of hiv, features of the uveitis, concurrent disease and CD4 counts. Only 12 patients were identified to have symptomatic uveitis out of a total 172 patients. There were 9 males and 3 females with an average age of 35 years. None of these patients were taking either rifabutin, protease inhibitors or cidofovir. Seven out of the 12 patients had granulomatous uveitis. Of these 7 patients, 4 had CD4 counts over 200 and no other concurrent illness whilst 3 patients, with CD4 counts between 130-200, were subsequently found to have an underlying aetiology namely lymphoma, tuberculosis and candida. The remaining 5 patients, all with CD4 counts below 40, had a history of systemic illness with herpes zoster preceding the onset of the uveitis. hiv-positive patients with symptoms of uveitis do not have active CMVR and the ophthalmologist must search for other causes such as tuberculosis or lymphoma in those with granulomatous uveitis or herpes zoster in those with non-granulomatous uveitis. The CD4 count may be helpful.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
3/11. cryptosporidiosis leading to an unsuspected diagnosis of AIDS.We describe a 68-year-old woman with an episode of diarrhoea, malaise and weight loss, caused by infection with cryptosporidium. The diagnosis was hampered because this patient had a low risk of hiv infection, a two-year history of Crohn's disease, and a simultaneous candidal infection. An infection with cryptosporidium was demonstrated with electron microscopic examination, and subsequent tests revealed positive hiv serology. AIDS was probably contracted through her husband.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
4/11. Disseminated strongyloides stercoralis in AIDS: a report from india.We report a fatal case of disseminated strongyloidiasis masquerading clinically as stage IV caecal malignancy diagnosed at post mortem by needle necropsy. The parasite was seen in the smears from CSF, pleural fluid, ascitic fluid, splenic aspirate, lung aspirate and aspirates from caecal area. Enteric organisms like Group D streptococci and candida sp were also associated. We believe that this is the first report of widespread dissemination of S. stercoralis in AIDS from india.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
5/11. Candida meningitis in a suspected immunosuppressive patient--a case report.meningitis due to fungal agents represents an AIDS-defining event and occurs typically with very low CD4 lymphocyte count. Candida meningitis is still a rare clinical condition, although it is becoming frequently reported in the background of immune suppressive states such as: drug addicts, cancer patients, organ transplant recipients and hiv/AIDS patients. In this report we highlight a case of candida meningitis, in a 25- year old female patient. She presented with vulva swelling, vaginal discharge and fever, with rapid progression to tonic-clonic convulsions and loss of consciousness. She fully recovered after treatment with fluconazole.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
6/11. Disseminated BK type polyomavirus infection in an AIDS patient associated with central nervous system disease.A 27-year-old man with hemophilia type A and acquired immunodeficiency syndrome developed a subacute meningoencephalitis, associated with a normotensive internal hydrocephalus, 14 weeks before his death. From cerebrospinal fluid and brain autopsy material, a virus could be isolated and was classified by Southern blot analysis and restriction endonuclease reactions as the human polyomavirus BK. The postmortem findings of polyomavirus antigen and bk virus dna in various cell types of the kidneys, lungs, and central nervous system strongly suggest that BK virus was the causative agent of a tubulointerstitial nephropathy, an interstitial desquamative pneumonitis, and a subacute meningoencephalitis with accentuation of the ventricular and meningeal surfaces of the brain. Besides distinctive cytopathic effects, the presence of intranuclear inclusions was a prominent histopathological feature. Therefore, the human polyomavirus BK should be regarded as a new candidate on the still growing list of opportunistic pathogens in acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
7/11. Invasive fungal sinusitis in immunosuppressed patients. Report of three cases.Report of three cases. Newly appeared immunosuppression related conditions have led to an increase in morbidity of systemic opportunistic mycoses. Rhinosinusal infection has also increased in frequency. Three invasive nasosinusal mycoses are presented: two cases of mucormycosis and a simultaneous infection by mucormycosis and candida albicans. In all cases, and despite treatment, progression of the disease could not be stopped and the patients died. The main characteristics of invasive nasosinusal mycoses are reviewed, to obtain early diagnosis. Early therapy improves the prognosis, and thus clinical suspicion justifies treatment before establishing a microbiological diagnosis.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
8/11. Adenovirus mixture isolated from the brain of an AIDS patient with encephalitis.A mixture of adenoviruses 31 and 49 was isolated from the brain of an AIDS patient with encephalitis. Adenovirus hexon protein was detected in neurons by indirect immunofluorescence. By restriction endonuclease analysis both adenovirus 31 and 49 were shown to be new genotypes. This is the first report of the isolation of a mixture of adenoviruses from adenovirus encephalitis and the first association of adenovirus 49, a new candidate serotype, with encephalitis.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
9/11. Candidal meningitis in hiv-infected patients: analysis of 14 cases.Five cases of candidal meningitis in human immunodeficiency virus (hiv)-infected patients have been diagnosed in our hospital. This article describes these cases and reviews another nine previously reported in the literature. Most patients (71%) had at least one well-known predisposing factor for candidiasis. Median CD4 cell count was 135/mm3. headache and fever, in the absence of focal neurologic signs, were the predominant clinical features. The CSF analysis revealed mild pleocytosis and hypoglycorrachia, indistinguishable from those seen in tuberculous or cryptococcal meningitis. Twelve patients (92%) received amphotericin b for a median of 51 days, in combination with flucytosine in five cases. The overall mortality among treated patients was 31%. Although the risk of relapse of candidal meningitis is unknown, maintenance antifungal therapy was given to seven patients (63%), usually with fluconazole. Candida species must be kept in mind as a cause of chronic meningitis in hiv-infected patients who have a known predisposing factor.- - - - - - - - - - ranking = 2keywords = candida (Clic here for more details about this article) |
10/11. Successful medical management of isolated renal zygomycosis: case report and review.We describe the medical management of isolated renal zygomycosis in an adult patient with AIDS during chemotherapy for AIDS-related lymphoma. After initial presentation during the first cycle of chemotherapy, the infection was contained within the kidney following recovery of the neutrophil count without medical or surgical intervention. Since he was not considered to be a candidate for nephrectomy, his infection was treated with amphotericin b lipid complex during subsequent chemotherapy. neutropenia was minimized by the addition of cytokine support therapy with granulocyte colony-stimulating factor and reduced doses of chemotherapy. Following this strategy, his lymphoma completely resolved, and renal zygomycosis was controlled. At the time of this writing, he had been in complete remission for 18 months without evidence of progressive fungal infection. This report and our literature review indicate that isolated renal zygomycosis can be associated with a favorable prognosis, occurs with greatest frequency in patients with AIDS, is associated with parenteral access, and may be managed by medical therapy alone.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
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