Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Strongyloides stercoralis is an intestinal nematode which infects a large portion of the world's population. Individuals with infection confined to the intestinal tract are often asymptomatic but may have abdominal pain, weight loss, diarrhea, and other nonspecific complaints. Enhanced proliferation of the parasite in compromised hosts causes an augmentation of the normal life-cycle. Resultant massive invasion of the gastrointestinal tract and lungs is termed the hyperinfection syndrome. If the worm burden is excessive, parasitic invasion of other tissues occurs and is termed disseminated strongyloidiasis. A variety of underlying conditions appear to predispose to severe infections. These are primarily diseases characterized by immunodeficiency due to defective T-lymphocyte function (Table 1). Individuals with less severe disorders become compromised hosts because of therapeutic regimens consisting of corticosteroids or other immunosuppressive medication. The debilitation of chronic illness or malnutrition also predisposes to systemic stronglyloidiasis. The diagnosis of strongyloidiasis can be readily made by microscopic examination of concentrates of upper small bowel fluid, stool, or sputum. Important clues suggesting this infection include unexplained gram-negative bacillary bacteremia in a compromised host who may have vague abdominal complaints, an ileus pattern on X-ray, and pulmonary infiltrates. Eosinophilia is helpful, if present, but should not be relied upon to exclude the diagnosis. The treatment of systemic infection due to Strongyloides stercoralis with either thiabensazole 25 mg/kg orally twice daily is satisfactory if the diagnosis is made early. Because of several unusual features of this illness in compromised hosts, the standard recommendation for 2 days of therapy should be abandoned in such patients. Immunodeficiency, corticosteroids, and bowel ileus reduce drug efficacy. Thus a longer treatment period of at leuch as blind loops or diverticula necessitate longer treatment. Stool specimens and upper small bowel aspirates should be monitored regularly and treatment continued several days beyond the last evidence of the parasite. In particularly difficult situations where either worm eradication is impossible or reinfection is probable, short monthly courses of antihelminthic therapy seem to be effective in averting recurrent systemic illness. Finally, prevention of hyperinfection or dissemination due to Strongyloides stercoralis can be accomplished by screening immunocompromised hosts with stool and upper small bowel aspirate examinations. These would be especially important prior to initiating chemotherapy, or before giving immunosuppressive medications or corticosteroids to patients with nonneoplastic conditions such as systemic lupus erythematosus, nephrotic syndrome, or renal allografts.
 ...
PMID:Overwhelming strongyloidiasis: an unappreciated opportunistic infection. 36 22

The product-limit incidence of Mycobacterium avium-intracellulare complex (MAC) bacteremia in 1006 human immunodeficiency virus (HIV)-positive patients followed at one institution over a 3-year period from the day of AIDS diagnosis with monthly lysis-centrifugation blood cultures was 21% +/- 2% SE at 1 year and 43% +/- 3% at 2 years. The product-limit incidence of MAC bacteremia at 1 year after the patients' first CD4 cell count was related to both the CD4 cell count and to whether they had an AIDS diagnosis (both P less than .0001) but not to age, sex, or race. This incidence was 39% +/- 6% for CD4 cell counts of less than 10/mm3, 30% +/- 5% for 10-19/mm3, 20% +/- 4% for 20-39/mm3, 15% +/- 4% for 40-59/mm3, 8% +/- 3% for 60-99/mm3, and 3% +/- 1% for 100-199/mm3. MAC may eventually infect most if not all HIV-positive patients who do not die from another HIV-related event.
 ...
PMID:Incidence of Mycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients. 134 6

Aseptic venipuncture was used to obtain samples of blood from 22 patients seropositive for human immunodeficiency virus (HIV) with gingivitis (HIV-G) and 19 HIV-seropositive patients with periodontitis (HIV-P), 15 and 30 minutes after the initiation of routine dental scaling and root planing. The presence of colony forming units in 1.2 ml aliquots of blood collected with the Isostate system (DuPont Isostat System, Doraville, Ga.) was assayed on trypticase soy blood agar. Six of the samples from HIV-G subjects were positive for colony forming units 15 minutes after scaling but not at 30 minutes. Similar evidence of bacteremia was found in seven of the HIV-P patients 15 minutes after scaling was initiated in this group, with no microbial growth detectable in samples obtained at 30 minutes. In two HIV-G and three HIV-P patients with demonstrable bacteremias a postoperative fever developed. For both HIV-G and HIV-P groups no significant difference was found between the absolute CD4 T-cell counts of nonbacteremic versus bacteremic patients (p greater than 0.05). These observations suggest that special provisions for antibiotic prophylaxis in this patient group may be unnecessary.
 ...
PMID:Postscaling bacteremia in HIV-associated gingivitis and periodontitis. 151 41

Thirteen bacteremias and 25 nonbacteremic infections caused by Pseudomonas spp. occurred in 22 of 236 children with human immunodeficiency virus infection with a rate of infection of 0.098 (bacteremia, 0.030) per patient year. Four patients were neutropenic (less than 500/microliters). Central venous catheter (CVC)-related infections were most frequent (n = 20) followed by otitis externa (n = 6) and pneumonia (n = 5). Pseudomonas aeruginosa was the most common isolate and caused both CVC-related and CVC-unrelated infections, whereas other Pseudomonas spp. and Xanthomonas maltophilia were almost exclusively associated with CVC-related infections. The children who received appropriate therapy had a favorable outcome. In 7 CVC-related infections (35%) the catheter was removed. Pseudomonas spp. are of increasing importance in human immunodeficiency virus-infected children causing significant morbidity and increased hospitalization. These infections may be life-threatening if appropriate therapy is not vigorously initiated.
 ...
PMID:Pseudomonas infections in children with human immunodeficiency virus infection. 152 45

Bacterial infections are a well-described complication of AIDS. However, relatively few reports have described infections due to Pseudomonas aeruginosa in adults who are infected with the human immunodeficiency virus (HIV). Seven cases of serious P. aeruginosa infection in HIV-infected patients occurred during 12 months in two hospitals in Houston, often in the absence of other host factors that are generally thought to predispose to this condition. One patient had no prior illness or antibody test results that were suggestive of HIV infection; for two other patients who were known to have antibody to HIV, an AIDS-defining diagnosis had never been made. Three patients had pneumonia (two with bacteremia and one with empyema), one had malignant otitis externa, and three had bacteremia that either resulted from or caused secondarily a soft-tissue focus of infection. Two patients died, and two others experienced one or more relapses after an initial course of treatment. Compromised host defense mechanisms, including loss of mucosal integrity, defects in humoral and cellular immunities, and qualitative or quantitative leukocyte abnormalities, may predispose HIV-infected patients to P. aeruginosa infections.
 ...
PMID:Life-threatening Pseudomonas aeruginosa infections in patients with human immunodeficiency virus infection. 155 24

Although AIDS was largely recognized and defined because of the increased presence of diseases that reflect deficiencies in cell-mediated immunity, susceptibility to common extracellular bacterial pathogens has also been shown to be increased. To our knowledge, adults with concurrent infection due to human immunodeficiency virus (HIV) and Streptococcus pneumoniae whose cases have been described to date have all had pneumococcal pneumonia and/or bacteremia. We describe five cases of HIV-infected patients who had unusual manifestations of pneumococcal infection, which include recurrent exudative pleural effusion, pyopneumothorax, purpura fulminans, mediastinitis with chest wall abscess, and multiple brain abscesses. Such complications of pneumococcal infection occurred more or less commonly in the preantibiotic era, but on the basis of our experience and an exhaustive literature search, these complications have been exceedingly rare in the past few decades. In four of our five patients, the unusual, complicated pneumococcal disease preceded and prompted a search for HIV infection. Because concurrent HIV infection increases the susceptibility to pneumococcal disease, other such cases are likely to be seen.
 ...
PMID:Unusual manifestations of pneumococcal infection in human immunodeficiency virus-infected individuals: the past revisited. 157 28

We conducted a retrospective study to analyze the impact of central venous catheters (CVCs) and antiretroviral therapy on the frequency and the patterns of bacterial infections in children infected with human immunodeficiency virus during a 3-year period. Among 204 bacterial infections other than otitis media reviewed, soft tissue infection (n = 69), bacteremia (n = 57), pneumonia (n = 27) and sinusitis (n = 27) were encountered most frequently. Catheter-related staphylococcal infection was the most common infection in children with CVCs, particularly in those who were less than 6 years old. In children without CVCs, Streptococcus pneumoniae was the most frequent organism. Younger children had more CVC-related infections whereas children with lower CD4 counts had more CVC-related and CVC-unrelated infections. A lower frequency of CVC-unrelated infections was detected in patients who received antiretroviral therapy, especially those receiving a continuous infusion of zidovudine. These data suggest that increased frequency and altered patterns of bacterial infections are associated with the use of CVCs in these patients, but antiretroviral therapy may reduce the frequency of CVC-unrelated infections.
 ...
PMID:Bacterial infections in human immunodeficiency virus type 1-infected children: the impact of central venous catheters and antiretroviral agents. 166 Oct 3

A 36-year-old homosexual man who was infected with human immunodeficiency virus presented with a 2-month history of fever and intermittent diarrhea. Stool cultures were negative for bacterial pathogens, ova, parasites, and acid-fast organisms. An initial blood culture became positive after 5 days for a curved, gram-negative rod that was identified later as Campylobacter cinaedi. The patient received a series of antibiotic regimens, including a 2-week course of erythromycin followed by a 2-week course of tetracycline, but follow-up blood cultures continued to yield C. cinaedi. The patient was then treated with a 2-week course of oral ciprofloxacin; he remained asymptomatic 11 weeks later, at which time a blood culture was negative for C. cinaedi. To the best of our knowledge, this is the first documented case of symptomatic bacteremia due to C. cinaedi that was successfully treated with ciprofloxacin.
 ...
PMID:Use of ciprofloxacin for successful eradication of bacteremia due to Campylobacter cinaedi in a human immunodeficiency virus-infected person. 161 64

Proof of hematogenous dissemination of Mycobacterium tuberculosis was initially reported in the early 1900s and was noted to be most frequent in patients with miliary tuberculosis. More recently, M. tuberculosis bacteremia has been reported in human immunodeficiency virus (HIV)-infected patients. We describe 13 adult HIV-infected patients in whom hematogenous M. tuberculosis dissemination was evident. Although for most patients whose bone marrow aspirate cultures yielded M. tuberculosis a chest roentgenogram revealed a miliary pattern, roentgenograms for those with M. tuberculosis bacteremia usually revealed evidence of lobar or diffuse infiltrates. Most patients with M. tuberculosis bacteremia had other risk factors for M. tuberculosis, and many had a rapid death, suggesting acute fulminant infection. Our own experience suggests that there are various syndromes associated with hematogenous dissemination in patients infected with M. tuberculosis.
 ...
PMID:Hematogenous dissemination of Mycobacterium tuberculosis in patients with AIDS. 177 42

Five patients with AIDS and Listeria monocytogenes infection (three cases of bacteremia and two of meningitis) are reviewed. Four patients had prior or concurrent gastrointestinal illness. Two patients received corticosteroids. A 7- to 21-day course of ampicillin was administered with or without a 7- to 14-day course of gentamicin. This regimen was effective, with no evidence of relapse 7-8 months after therapy was discontinued. The relative infrequency of infection with L. monocytogenes in AIDS patients is unexpected. Tumor necrosis factor (TNF) appears to be essential in the inhibition of Listeria in vivo. Elevated levels of TNF in AIDS patients may be protective against listeriosis and thus help explain the low prevalence of listerial infection in this population. Nonetheless, although L. monocytogenes is an uncommon cause of illness in patients infected with the human immunodeficiency virus, it cannot be dismissed as a cause of undefined meningitis or sepsis.
 ...
PMID:Listeria monocytogenes infections in patients with AIDS: report of five cases and review. 186 44


1 2 3 4 5 6 7 8 9 10 Next >>