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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adherent cells from human immunodeficiency virus (HIV)-infected subjects but not from normal blood donors, patients with Gram-positive or -negative bacteremia, active tuberculosis, toxoplasmosis, pulmonary aspergillosis, and cytomegalovirus infection produce spontaneously an activity which inhibits alpha chain of interleukin-2 (Tac) expression and interleukin 2 (IL-2) production by normal activated T cells and IL-2 production by these cells. A similar biologic activity was detected in culture supernatants of in vitro HIV-I-infected normal adherent and leukemic U937 cells. Tac-inhibitory activity is not cytotoxic and it could be detected in serum-free conditioned media. Recombinant granulocyte/macrophage colony-stimulating factor and phorbol myristate acetate stimulation of patients' and normal adherent cells did not enhance specifically the production of the Tac inhibitor. Biologically active conditioned media did not contain infectious virus as well as secreted p24, gp120 viral proteins; the biologic activity could not be abolished by anti-p24, anti-gp120, and anti-nef monoclonal antibodies or human purified polyclonal anti-HIV IgG. Gel filtration of conditioned media followed by anion exchange chromatography resulted in a 1,200-fold degree of purification and revealed that the biologically active molecule was cationic. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of this fraction and gel elution of the proteins showed that the biologic activity was associated with a 29-kD protein which was distinct from alpha- or gamma-interferon, tumor necrosis factor-alpha, and prostaglandin E2. The above findings demonstrate the production of inhibitory factor(s) during HIV infection, which might be involved in the pathogenesis of the patients' immune defect.
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PMID:Biological and biochemical characterization of a factor produced spontaneously by adherent cells of human immunodeficiency virus-infected patients inhibiting interleukin-2 receptor alpha chain (Tac) expression on normal T cells. 190 71

The incidence of bacterial pneumonia is increased in human immunodeficiency virus (HIV) infection, and bacteremia and recurrences occur frequently. Streptococcus pneumoniae and Haemophilus influenzae are the most common pathogens, but several other organisms have now been identified as etiologies. Several abnormalities in B-cells and humoral immunity, and possibly neutropenia and white blood cell dysfunction, predispose to bacterial pneumonia. Despite the severity of pneumonia in HIV infection, most patients respond well to specific antimicrobial chemotherapy. Potential preventive measures include vaccines, immunoglobulin therapy, and antimicrobial prophylaxis.
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PMID:Bacterial pneumonia in the HIV-infected patient. 195 96

Although resistance to Listeria monocytogenes infection requires intact T cell-mediated immunity, only 20 patients with human immunodeficiency virus (HIV) infection and listeriosis (including one patient described herein) have been reported to date. Listeriosis developed before AIDS in five cases. Syndromes included meningitis in nine cases, bacteremia in nine, brain abscess in one, and endocarditis in one. Eighteen patients were treated with ampicillin, penicillin, or amoxicillin with or without aminoglycosides. Clinical and microbiologic responses were obtained in one patient with bacteremia treated with vancomycin and in one patient with meningitis treated with trimethoprim-sulfamethoxazole. Three of the nine patients with meningitis died, as did the patient with brain abscess. All nine patients with bacteremia and the patient with endocarditis survived. No case of relapse was documented. L. monocytogenes, although uncommon, should be considered in the differential diagnosis of febrile illness, meningitis, and brain abscess in patients with HIV infection.
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PMID:Listeriosis in patients infected with human immunodeficiency virus. 201 9

Although listeriosis is an uncommon infection in patients with human immunodeficiency virus (HIV) infection, the frequency of listeriosis in New York City has increased because of the increase in the number of HIV-infected patients. The medical records of 30 patients admitted to three medical centers in New York City from 1981 to 1988 with infections due to Listeria monocytogenes were reviewed. Six patients had AIDS, one was seropositive and asymptomatic, and four had risk factors for HIV infection. While the annual number of cases of listeriosis in patients without risk factors for HIV infection was constant, 9 of the 11 patients with AIDS or with risk factors for HIV infection presented with listeriosis between 1985 and 1988, the last half of the survey period. These patients were male homosexuals or intravenous drug abusers, and all but one were black or Hispanic. Manifestations of listeriosis in patients with AIDS or with risk factors for HIV infection included bacteremia without apparent source in seven, meningitis in three, and endocarditis in one, syndromes that were similar to those in patients without risk factors for HIV infection. Ten of 11 patients were treated with penicillin or ampicillin, and 7 were also given an aminoglycoside. All patients responded well to therapy and no relapses were observed. Physicians should include antibiotics effective against L. monocytogenes when treating AIDS patients with meningitis of unknown origin and consider the diagnosis of listeriosis in patients with sepsis of unknown origin.
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PMID:Listeriosis in patients with HIV infection: clinical manifestations and response to therapy. 210 31

Mycobacterium tuberculosis bacteremia is being reported more frequently in patients with human immunodeficiency virus, type 1 (HIV-1) infection. We report 9 patients with bacteremia due to M. tuberculosis and HIV infection who were identified over a 36-month period. Of the 9 patients studied, 8 were male, 8 were black, 6 were born in Haiti, 3 were homeless, 2 were intravenous drug users, and 1 was homosexual. At the time of diagnosis, 3 patients had the acquired immunodeficiency syndrome (AIDS) and 5 patients had CD4 lymphocyte counts less than or equal to 170 cells/mm3, indicating marked immunodeficiency. All 9 patients presented with temperature greater than 38.3 degrees C, 5 (50%) had abnormal chest roentgenogram on admission, and each of the patients tested had elevations of at least 2 liver function tests. Eight patients (80%) had M. tuberculosis isolated from sputum or other body fluids and tissues. All blood isolates of M. tuberculosis were identified from Dupont Isolator tubes. Antibiotic-resistant isolates of M. tuberculosis were cultured from 3 of the 6 patients born in Haiti. One patient died before diagnosis and received no antimycobacterial therapy; 7 of the remaining 8 patients appeared to respond to treatment. Our data, and a review of the literature, suggest that bacteremia due to M. tuberculosis is becoming more frequent, and that blood cultures may be helpful in establishing or confirming a diagnosis of tuberculosis in patients with HIV-1 infection.
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PMID:Bacteremia due to Mycobacterium tuberculosis in patients with human immunodeficiency virus infection. A report of 9 cases and a review of the literature. 212 71

Etoposide was found to be schedule-dependent in both preclinical and clinical trials. A study was initiated in March 1988 at Indiana University (Indianapolis, IN), using daily oral etoposide in patients with refractory germ cell tumors. The dose was 50 mg/m2/d, administered daily until progression or toxicity not ameliorated by dose adjustment occurred. Twenty-two patients have been entered to date. Primary sites were testis (11 patients), retroperitoneum (five patients), and mediastinum (six patients). All 22 patients had had previous treatment with cisplatin/etoposide combination regimens, including six patients who were also previously treated with high-dose etoposide and carboplatin with autologous bone marrow transplantation. The median number of treatment regimens was 2.9 (range, 1 to 4). Five patients had progressive disease during treatment with etoposide. Median length of treatment was 11.5 weeks (range, 2 to 30), with six patients continuing on treatment. Median white blood cell nadir was 1.5 x 10(9)/L, median hemoglobin nadir 9.1 g/dL, and the median platelet nadir 184,000/microL. Granulocytopenia required temporary cessation of treatment in eight patients and dose reductions in four. Five patients developed granulocytopenic fevers, including pneumonia (two patients) and bacteremia (one patient). Additionally, two patients (who tested negative for human immunodeficiency virus) died from Pneumocystis pneumonia with granulocyte counts higher than 500/microL. Of 21 evaluable patients (there was one protocol violation), three responded with a greater than 90% decrease in markers and a greater than 50% decrease in measurable radiographic disease. One of these had previously progressed on cisplatin/etoposide combination therapy. Three other patients responded with a greater than 90% decrease in markers but with stable radiographic disease; two of them had previously resected teratoma. The remaining ten patients were nonresponders. In conclusion, daily oral etoposide has definite activity in refractory germ cell tumors. Further evaluation of this regimen is warranted.
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PMID:Phase II study of daily oral etoposide in refractory germ cell tumors. 215 58

The leukocyte count, the differential leukocyte count and the erythrocyte sedimentation rate (ESR) are the more commonly used tests for diagnosing or managing an inflammatory process. Measurements of acute-phase proteins has an advantage over that of the leukocyte count and ESR. Especially microscopic examination of peripheral blood smear can be time consuming, but the simple and inexpensive technique is still clinically useful when a high grade bacteremia is likely to be present. Although the results are examiner dependent, it should be reliable in the proper clinical setting. In the guidelines for the selection of laboratory tests for monitoring the acute phase response, published in 1988, the International Committee for Standardization in hematology (ICSH) considered the biohazzard of ESR. Therefore the ESR should not routinely be performed on blood samples from patients who show a positive test for hepatitis virus or human immunodeficiency virus. The subcommittee for laboratory tests in daily care situations in Japan Society of Clinical Pathology published the "Essential Laboratory Tests" in 1989. We conclude that the differential leukocyte counts and the ESR should be used to follow the activity and response to treatment of certain inflammatory disorders when other objective indicators are not available.
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PMID:[Inflammatory reaction and laboratory tests: hematologic examination]. 219 24

A new pathogenetic pattern of pseudotuberculosis has been derived on the basis of original clinical, anatomical and experimental findings as well as literature data. Careful consideration is given to: a basic mode of infection (alimentary), emergence of the primary affection with a rapid blood invasion by the agent (primary bacteremia), development of specific sensitization, multiorgan secondary focal impairment with lymphogenic dissemination of the infective agent (specific pseudotuberculous polyadenitis), formation of secondary immunodeficiency, consequent repeat bacteremias, recurrences, symptoms of infectious process aggravations, immunological rearrangement with dominating delayed hypersensitivity. As a rule, the disease terminated by elimination of the secondary foci and recovery.
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PMID:[The basic features of the pathogenesis of pseudotuberculosis (yersiniosis)]. 220 25

Human immunodeficiency virus (HIV) is an important risk factor for invasive pneumococcal disease, but information on clinical course and infecting serotypes is limited. To help develop strategies to reduce the morbidity due to invasive pneumococcal disease, episodes of pneumococcal bacteremia were identified by retrospective review of microbiology records (November 1983-November 1987) at 10 San Francisco hospitals and, for patients 20-55 years old living in San Francisco, HIV antibody status was determined by review of medical records. Pneumococcal isolates from one hospital were serotyped. Of 294 patients with pneumococcal bacteremia identified, 32 (11%) had AIDS at the time pneumococcal bacteremia was diagnosed and another 43 (15%) were HIV-infected but did not have AIDS; 12 HIV-infected patients developed AIDS after the episode of pneumococcal bacteremia. The rate of pneumococcal bacteremia in AIDS patients was estimated to be 9.4/1000 patient-years. Serotypes of 27 (82%) of 33 pneumococcal isolates from HIV-infected patients and 107 (90%) from 119 patients without known HIV infection were among the 23 serotypes included in the currently available polysaccharide vaccine. The rate of pneumococcal bacteremia is approximately 100-fold greater in AIDS patients in San Francisco than rates reported before the AIDS epidemic, but more than half the episodes of pneumococcal bacteremia in HIV-infected patients occurred in patients without AIDS. Data on pneumococcal serotypes causing invasive disease in HIV-infected patients suggest that the current pneumococcal vaccine, if effective in this population, could provide significant protection against pneumococcal disease.
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PMID:The role of human immunodeficiency virus infection in pneumococcal bacteremia in San Francisco residents. 223 Feb 29

Listeria monocytogenes bacteremia without meningitis has been reported in patients who have undergone long-term hemodialysis and have transfusional iron overload. On the other hand, cases of Listeria bacteremia without meningitis have occurred sporadically among the acquired immunodeficiency syndrome population, mostly homosexuals. There have been no reports of Listeria meningitis occurring among persons who are antibody positive to human immunodeficiency virus or are intravenous drug abusers having chronic renal failure and undergoing hemodialysis. This patient represents the first case of Listeria bacteremia and meningitis to occur in an intravenous drug abuser who is human immunodeficient antibody positive, is receiving hemodialysis, and has transfusional iron overload.
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PMID:Listeria monocytogenes meningitis in a human immunodeficiency virus-positive patient undergoing hemodialysis. 229 86


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