1/1541. thrombotic microangiopathies and HIV infection: report of two typical cases, features of HUS and TTP, and review of the literature.Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are thrombotic microangiopathies increasingly reported in patients with HIV infection. However, characteristic features of thrombotic microangiopathies associated with HIV disease have not been defined yet. The typical courses of HUS and TTP in two patients are presented. The data as well as the analysis of cases published in the literature demonstrate the association of thrombotic microangiopathies with late-stage HIV disease. Moreover, differences between HUS and TTP can be detected. patients with HUS present with more severe immunologic deterioration. Although clinical symptoms are fewer, HUS implicates a very poor prognosis. life expectancy rarely exceeded 1 year after diagnosis. HUS and TTP should therefore be added to the international AIDS classification.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/1541. Pseudogaucher cells in cutaneous mycobacterium avium intracellulare infection: report of a case.We report on a patient infected with human immunodeficiency virus, and with cutaneous mycobacterium avium intracellulare, in whom many cells with abundant reticulated cytoplasm resembling the characteristic cells of Gauchers disease ("pseudogaucher cells") were noted within the dermal infiltrate on biopsy. Although pseudogaucher cells have been reported in association with M. avium intracellulare infection in extracutaneous sites, this is, to our knowledge, the first report of cutaneous pseudogaucher cells in the skin.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/1541. Laryngeal pathology in the acquired immunodeficiency syndrome: diagnostic and therapeutic dilemmas.The acquired immunodeficiency syndrome has produced a growing population of patients who, because of their associated immune system compromise, are prone to opportunistic infections and neoplastic diseases. The larynx, with its relatively inaccessible yet critical anatomic location, is a site in which these processes can produce clinical dilemmas, with respect to diagnosis as well as to therapy. By presenting 4 cases involving unusual laryngeal problems in patients infected with the human immunodeficiency virus (HIV), we emphasize these inherent diagnostic and therapeutic problems. Otolaryngologists must be familiar with the many diagnostic possibilities and therapeutic alternatives when HIV-infected patients present with laryngeal complaints.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
4/1541. arthritis due to mycobacterium fortuitum.mycobacterium fortuitum is classified as a rapidly growing mycobacterium (RGM) according to the Runyon classification. RGM are increasingly being recognized as human pathogens. Joint infection due to M. fortuitum is a rare, but serious disease. This report describes a patient with acquired immunodeficiency syndrome (AIDS) and septic arthritis of the knee due to M. fortuitum in a previously normal joint with no history of surgery or intra-articular injections.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
5/1541. Progressive outer retinal necrosis syndrome as an early manifestation of human immunodeficiency virus infection.Progressive outer retinal necrosis syndrome is a recently recognized variant of necrotizing herpetic retinopathy, developing in patients with acquired immune deficiency syndrome (AIDS) or other conditions causing immune compromise. We report a case in which the diagnosis of retinal necrosis syndrome was made before the diagnosis of AIDS was confirmed. A 41-year-old man presented with a 1-month history of blurred vision in his left eye. Ophthalmologic examination revealed extensive retinal necrosis with total retinal detachment in his left eye and multifocal deep retinal lesions scattered in the posterior fundus as well as in the peripheral retina in his right eye. The serologic test for human immunodeficiency virus (HIV) was positive. Despite intravenous acyclovir treatment for 1 week, the lesions in the right eye showed rapid progression. High doses of intravitreal ganciclovir were then given in addition to intravenous acyclovir. After combined treatment for 1 month, the lesions became quiescent and the visual acuity improved to 20/30. Although the patient soon developed full-blown AIDS, the vision in his right eye remained undisturbed. physicians should suspect progressive outer retinal necrosis syndrome in any patient with rapidly progressive necrotizing retinopathy and test the patient for HIV infection. Aggressive combined antiviral agent therapy should be considered to save vision.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/1541. Pulmonary malacoplakia associated with rhodococcus equi infection in a patient with AIDS.An AIDS patient with a cavitary lung lesion was found to have pulmonary malacoplakia associated with rhodococcus equi infection. The diagnosis was based on the typical histologic features of transbronchial biopsy and a positive bacterial culture. All 13 reported cases of AIDS patients with pulmonary malacoplakia were associated with R equi. The recognition of this unique entity is important because of its responsiveness to therapy.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/1541. Rapid and definitive diagnosis of infectious diseases using peripheral blood smears.A timely diagnosis is essential in the management of septicemia and septic shock. Three patients are described, all of whom presented with fever and one of whom was hypotensive at the time of admission. In each patient, rapid diagnosis of the cause of fever was possible because microorganisms were identified on a peripheral blood smear obtained at the time of admission. This identification permitted prompt initiation of appropriate antimicrobial therapy. In addition, a literature review of use of peripheral blood smears in the diagnosis of bacterial, fungal, and parasitic infections is provided.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
8/1541. An HIV autopsy--characterization of zidovudine-resistant subtype E hiv-1 from autopsy tissue suggests the route of infection and an alternative protocol of therapy.This CPC concerns a 47-year-old male patient with acquired immunodeficiency syndrome (AIDS). The patient became symptomatic when he developed pneumocystis carinii pneumonia, but recovered sufficiently to be treated as an outpatient. Two years after falling ill, he developed septic shock and died within a short time. During this period, he failed to respond to HIV drugs, and there was no improvement in his immunodeficient status. The HIV retrieved from the patient's organs at autopsy was found to be type E and to have acquired resistance to zidovudine. It was also possible to determine the route of infection. HIV treatment guidelines are continuously being revised on the basis of HIV research and the development of new treatment plans, and at the present time, when no definitive method of treatment has yet been established, it is essential for the clinician to keep abreast of the latest information. Since HIV patients are compromised hosts, it is important to diagnose and treat other infectious complications, not only complications unique to AIDS, and we have briefly described the latest HIV therapy.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/1541. Persistently negative hiv-1 antibody enzyme immunoassay screening results for patients with hiv-1 infection and AIDS: serologic, clinical, and virologic results. Seronegative AIDS Clinical Study Group.OBJECTIVE: To describe persons with HIV infection and AIDS but with persistently negative HIV antibody enzyme immunoassay (EIA) results. DESIGN: Surveillance for persons meeting a case definition for hiv-1-seronegative AIDS. SETTING: united states and canada. patients: A total of eight patients with seronegative AIDS identified from July 1995 through September 1997. MAIN OUTCOME MEASURES: Clinical history of HIV disease, history of HIV test results, and CD4 cell counts from medical record review; results of testing with a panel of EIA for antibodies to hiv-1, and hiv-1 p24 antigen; and viral subtype. RESULTS: Negative HIV EIA results occurred at CD4 cell counts of 0-230 x 10(6)/l, and at HIV rna concentrations of 105,000-7,943,000 copies/ml. Using a panel of HIV EIA on sera from three patients, none of the HIV EIA detected infection with hiv-1, and signal-to-cut-off ratios were < or = 0.8 or all test kits evaluated. Sera from five patients showed weak reactivity in some HIV EIA, but were non-reactive in other HIV EIA. All patients were infected with hiv-1 subtype B. CONCLUSIONS: Rarely, results of EIA tests for antibodies to hiv-1 may be persistently negative in some hiv-1 subtype B-infected persons with AIDS. physicians treating patients with illnesses or CD4 cell counts suggestive of HIV infection, but for whom results of HIV EIA are negative, should consider p24 antigen, nucleic acid amplification, or viral culture testing to document the presence of HIV.- - - - - - - - - - ranking = 1.4keywords = infection (Clic here for more details about this article) |
10/1541. Resolution of disseminated molluscum contagiosum with Highly Active Anti-Retroviral Therapy (HAART) in patients with AIDS.molluscum contagiosum (MC), a cutaneous infection caused by a dna virus belonging to the poxvirus group, affects about 5-10% of patients with HIV disease, often showing extensive, severe lesions, unresponsive to therapy [1]. During the follow-up of three patients with AIDS for MC recalcitrant to therapy, we noted their cutaneous lesions cleared 5-6 months after they had begun Highly Active Anti-Retroviral Therapy (HAART). This therapy includes an hiv protease inhibitor (indinavir) and two reverse transcriptase inhibitors [2, 3].- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
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