1/19. Microbiological features of Papillon-Lefevre syndrome periodontitis.Papillon-Lefevre syndrome patients exhibit hyperkeratosis palmo-plantaris and severe periodontitis. The syndrome is an autosomal recessive trait, but the mechanism of periodontal destruction is not known. This report presents the clinical and microbiological features of an 11-year old girl with Papillon-Lefevre syndrome. Clinical examination included conventional periodontal measurements and radiographic analysis. In samples from 3 deep periodontal lesions, the occurrence of major suspected periodontopathic bacteria was determined by selective and non-selective culture and polymerase chain reaction (PCR) identification, and the presence of cytomegalovirus and Epstein-Barr type 1 virus by a nested-PCR detection method. 10 of 22 available teeth demonstrated severe periodontal breakdown. Major cultivable bacteria included actinobacillus actinomycetemcomitans (3.4% of total isolates), prevotella nigrescens (16.4%), fusobacterium nucleatum (14.3%) and peptostreptococcus micros (10.6%). A. actinomycetemcomitans, P. nigrescens, porphyromonas gingivalis and eikenella corrodens were identified by PCR analysis. The patient's non-affected parents and older brother revealed several periodontal pathogens but not A. actinomycetemcomitans. The viral examination demonstrated cytomegalovirus and Epstein-Barr type 1 virus in the subgingival sample of the Papillon-Lefevre syndrome patient. The father and brother yielded subgingival cytomegalovirus but not Epstein-Barr type 1 virus. We hypothesize that human herpesviruses in concert with A. actinomycetemcomitans play important roles in the development of Papillon-Lefevre syndrome periodontitis.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
2/19. In vivo down regulation of HIV replication after hepatitis c superinfection.There are increasing molecular and clinical evidences that the effects of human immunodeficiency virus (HIV) infection can be modified by coinfection with other viruses. The objective was to investigate the viral interaction between HIV and hepatitis c virus (HCV) after HCV superinfection. A 16 year-old pregnant woman was evaluated because of icteric acute hepatitis. Admission laboratory tests showed the following results: ALT 877 IU/L; AST 1822 IU/L; bilirubin 6.79 mg/dl. diagnosis of acute HCV was based on detection of serum HCV rna by PCR and anti-HCV seroconversion. ELISA for anti HIV testing was positive and confirmed by western blot. serum markers for other viruses were negative. The patient was followed during 19 months; serum samples were taken monthly during this period for detection of plasma HIV and HCV rna. Levels of plasma HIV-rna were positive in all samples tested before and after the onset of acute hepatitis c. Six months later and a for two month period, and 13 months later for a period of one month HIV viremia was undetectable; then HIV-rna in plasma was detectable again. In conclusion, HCV superinfection may have temporarily interfered with HIV replication in our patient. The following observations support our hypothesis: it has been demonstrated that hiv-1 replication is suppressed by HCV core protein which has transcriptional regulation properties of several viral and cellular promoters. Clinical implications of this event are not generally known and the interaction between these two viruses in dual infections is worth considering.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
3/19. superinfection with a transmissible strain of pseudomonas aeruginosa in adults with cystic fibrosis chronically colonised by P aeruginosa.Infection with transmissible strains of pseudomonas aeruginosa can occur in uncolonised patients, but cross infection (superinfection) of patients already colonised withP aeruginosa has not been reported. With genotypic identification, we found superinfection by a multiresistant transmissible strain of P aeruginosa in four patients with cystic fibrosis (CF) who were already colonised by unique strains of P aeruginosa. No evidence of environmental contamination was found, but all patients became superinfected after contact with colonised individuals during inpatient stays. inpatients with CF who are colonised with P aeruginosa should be separated by strain type. Such strain typing can only be reliably done by genomic methods, but this has resource implications.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
4/19. hepatitis e virus superinfection in patients with chronic liver disease.Infection with hepatitis a virus (HAV) can cause severe illness in adult patients with chronic liver disease (CLD) caused by hepatitis c. In endemic areas such as South asia, however, most adult patients already have been exposed to HAV but could still be susceptible to hepatitis e virus (HEV) infection. We document that HEV superinfection in 4 of our CLD patients caused severe liver decompensation. We then determined the seroprevalence of HAV and HEV in 233 patients with stable CLD, with the goal of defining the need for protection against these viruses in these patients. overall, 41 (17.5%) of 233 CLD patients were HEV antibody immunoglobulin g (IgG)-positive, and 228 of 233 (97.8%) were HAV IgG-positive. As controls, we tested 90 age- and sex-matched healthy volunteer blood donors for HAV and HEV antibodies IgG. There was no difference in the percentage of CLD patients and blood donors positive for HEV antibody IgG (17.7% vs. 17.5%) or for HAV IgG (97.8% vs. 94%). No differences were observed in the severity of liver disease between previously HEV-exposed and -nonexposed patients. In conclusion, superinfection with HEV in patients with underlying CLD can cause severe hepatic decompensation leading to increased morbidity and mortality. The large majority of adult CLD patients in endemic countries are vulnerable to infection with HEV, but are protected against hepatitis A, and are ideal candidates for an HEV vaccine.- - - - - - - - - - ranking = 8.9833298647242keywords = mortality (Clic here for more details about this article) |
5/19. hepatitis c virus eradication associated with hepatitis b virus superinfection and development of a hepatitis b virus specific T cell response.BACKGROUND/AIMS: Specific T cell responses during acute hepatitis B and during chronic hepatitis c have been described in detail. However, the T cell responses during the rare setting of acute hepatitis b virus (HBV) infection in the course of chronic hepatitis c that eventually lead to clearance of both viruses are completely unknown. methods: We analyzed the virus specific CD4 and CD8 T cell response during an acute HBV superinfection in a patient with chronic hepatitis c. RESULTS: The patient eliminated hepatitis c virus (HCV)-rna and HBV-dna from serum soon after the clinical onset of acute hepatitis B. The HBV specific T cell response found in this patient corresponds to the typical response that has been described in acute hepatitis B without chronic HCV infection. In contrast the hepatitis c specific immune response was similar to that generally found in chronic hepatitis c despite the fact that the patient also eliminated HCV-rna. CONCLUSIONS: We hypothesize that the acute HBV infection induced a HBV specific T cell response which was associated with elimination HBV dna and HCV-rna, the latter possibly by bystander mechanisms, e.g. via secretion of cytokines. If such a non-specific bystander mechanism which has proven to be effective in the experimental setting and which is formally described here for a single patient can be shown to be a more general phenomenon, it may support the approach with new antiviral strategies, e.g. the induction of non-specific defense mechanisms against HCV.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
6/19. Primary B cell lymphoma of the rectum in a patient coinfected with hiv-1 and HTLV-I.This report describes a clinical case of a large cell, immunoblastic plasmacytoid malignant B-cell lymphoma of the rectum in an AIDS patient coinfected with HTLV-I. The malignant cells showed clonal genetic rearrangement of the HC (JH) and LCK genes. Infection by EBV was demonstrated serologically and with slot blots using genomic dna of the cancer cells. Southern blot analysis with dna extracted from the lymphoma cells were negative for HTLV-I. The patient received seven cycles of VACO-B which induced complete but transient clinical remission of the tumor. The final outcome of the patient is unknown.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
7/19. infectious mononucleosis.BACKGROUND: infectious mononucleosis is caused by the ubiquitous Epstein-Barr virus. It is a common condition usually affecting adolescents and young adults. Most cases are mild to moderate in severity with full recovery taking place over several weeks. More severe cases and unusual complications occasionally occur. OBJECTIVE: After presenting a case of severe infectious mononucleosis, the spectrum of disease is given. diagnosis and complications are reviewed as well as management including the possible role for antiviral medications or corticosteroid therapy. DISCUSSION: The majority of cases of infectious mononucleosis are self limiting and require only supportive care. More severe cases, although unusual, may require admission to hospital and even to an intensive care unit. Corticosteroid therapy may be indicated for severe airway obstruction or other severe complications, but should be avoided unless the benefits outweigh potential risks. Antiviral therapy has no proven benefit.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
8/19. Fatal hemorrhagic pneumonia caused by infection due to Kytococcus sedentarius--a pathogen or passenger?A 55-year old man developed a hemorrhagic pneumonia, likely due to infection with Kytococcus sedentarius during neutropenia following induction chemotherapy for acute myeloid leukemia. Severe mucosal barrier injury and the selective pressure of broad-spectrum antibiotics probably made it possible for this normally harmless commensal to penetrate the gut, spread through the blood stream, and invade the lungs.- - - - - - - - - - ranking = 0.5keywords = rate (Clic here for more details about this article) |
9/19. Fatal influenza A infection with staphylococcus aureus superinfection in a 49-year-old woman presenting as sudden death.A fatal case of influenza A infection with staphylococcus aureus superinfection in a previously healthy 49-year-old woman presenting as sudden, unexpected death is reported. autopsy revealed severe necrotizing tracheobronchitis and hemorrhagic pneumonia. Microscopic examination of the trachea and bronchi showed mucosal necrosis and a dense lympho-monocytic infiltration of all layers. The lungs showed focal hemorrhagic pneumonia. No pathological changes were detectable in the myocardium. influenza a virus was detected in bronchi and lung samples obtained during autopsy by the polymerase chain reaction (PCR) and bacterial superinfection with staphylococcus aureus was shown by culturing from tracheal, bronchial and pulmonary swabs obtained during autopsy. PCR assays for the detection of Panton-Valentine leukocidin performed from all samples were negative. This case demonstrates the need for an interdisciplinary approach towards an organism-specific diagnosis of potentially infection-related deaths undergoing a medico-legal autopsy. With improved diagnostic possibilities such as PCR and dna sequencing, forensic pathologists can, in close association with the field of microbiology, make a significant contribution to the detection of highly infectious agents which must be notified to the authorities. This will increase particularly the knowledge about the influence of these agents on sudden, unexpected deaths in outpatients.- - - - - - - - - - ranking = 8.2289097005434keywords = death, rate (Clic here for more details about this article) |
10/19. Fatal necrotizing fasciitis of dental origin.Necrotizing fasciitis is a potentially fatal, acute bacterial infection characterized by extensive fascial and subcutaneous tissue necrosis. Four factors that contribute significantly to the morbidity and mortality of necrotizing fasciitis are: 1) delayed treatment, due to difficulty in recognizing the condition; 2) inappropriate treatment; 3) host debilitation; and 4) a polymicrobial infection.- - - - - - - - - - ranking = 8.9833298647242keywords = mortality (Clic here for more details about this article) |
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