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Query: UMLS:C0004623 (bacterial infection)
15,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Human immunodeficiency virus (HIV) infection predisposes to bacterial infection at may sites but septic arthritis is notably uncommon. An HIV seropositive patient who presented with oligoarticular septic arthritis due to Salmonella enteritidis and who responded poorly to antibiotic therapy and repeated aspiration of involved joints is described. Unusual features included the clinical presentation of septic arthritis in more than one joint, a protracted clinical course with radiological destruction of the hip, bone marrow suppression induced by cotrimoxazole, and death thought to be due to a gastropathy induced by non-steroidal anti-inflammatory therapy at a time when the septic arthritis appeared to have responded to treatment. Cure of Salmonella septic arthritis in HIV infected patients may be difficult and require aggressive prolonged treatment. Septic arthritis should be considered in the differential diagnosis in a patient with HIV infection and arthritis.
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PMID:HIV infection and Salmonella septic arthritis. 850 62

Tuberculosis, a bacterial disease caused by the Mycobacterium tuberculosis complex, is becoming an increasingly common opportunistic disease in persons infected with the human immunodeficiency virus (HIV). M. tuberculosis is transmitted from person-to-person by airborne droplet nuclei. Persons who are exposed to these droplet nuclei in poorly ventilated environments are at risk of becoming infected with M. tuberculosis. HIV infection is probably the most significant risk factor associated with progression from latent M. tuberculosis infection to active disease. Thus, HIV-infected persons should avoid exposure to M. tuberculosis, they should be screened for evidence of latent infection with the tuberculin skin test, and they should be offered preventive therapy. Because many severely immunosuppressed anergic HIV-infected persons have been found to have an increased risk of developing active tuberculosis, decisions to use preventive therapy should be individualized on the basis of the local prevalence of tuberculosis and drug-resistance patterns. Persons with active tuberculosis should receive at least 6 months of treatment with recommended regimens, preferably with directly observed therapy, to ensure adequate bacteriologic response, completion of therapy, and cure. Chronic suppressive therapy after completion of therapy is currently not recommended.
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PMID:Tuberculosis as an opportunistic disease in persons infected with human immunodeficiency virus. 854 15

Invasive pneumococcal infection (IPI) is the most common serious bacterial infection in human immunodeficiency virus (HIV)-infected children. Data from a population-based pediatric HIV surveillance project were used to determine the incidence of IPI in HIV-infected children and to conduct a case-control study assessing potential risk factors for IPI in HIV-infected children. There were 50 episodes of IPI and a cumulative incidence of 6.1 cases/100 patient-years through age 7 years. Children with IPI were more likely to have a prior AIDS diagnosis (odds ratio, 4.2; 95% confidence interval, 1.2-15.1) and higher levels of IgG and IgM (P=.01) than were controls. In a separate case-control study, the manifestations of IPI in HIV-infected children were compared with those in HIV-negative controls. Focal complication rates in the 2 groups did not differ; however, HIV-infected children were less likely than controls to have leukocytosis (P<.001) and more likely to have isolates with penicillin resistance (P=.03).
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PMID:Invasive pneumococcal infections in human immunodeficiency virus-infected children. 860 65

Bacterial infections are common in persons with symptomatic disease caused by human immunodeficiency virus (HIV). Colonisation and infection with Staphylococcus aureus is present in 30% to 50% of persons with HIV disease. Risk factors for bacteraemia due to S. aureus include nasal colonisation, advanced HIV disease with CD4+ lymphocyte count < 100/mm3, prior hospitalisations, neutropenia, skin lesions, intravenous drug use, and the presence of invasive devices, such as intravenous catheters. Some antibiotics may increase the risk of S. aureus nasal colonisation, and others such as trimethoprim-sulphamethoxazole and rifabutin may reduce colonisation and disease. Preliminary data suggest that mupirocin may decrease nasal colonisation with S. aureus, but the optimal regimen, duration of effect, use, and concerns about resistance, need further evaluation. Recent data suggest that bacterial infection may accelerate the progression of HIV disease. The presence of bacterial superantigens or cytokines, such as the exotoxins present in many strains of S. aureus have been shown to induce HIV production in human peripheral blood mononuclear leukocyte cultures in vitro, although the precise mechanism is unclear. Thus, HIV infection may increase the risk of S. aureus colonisation and disease and, in turn, infection or colonisation with S. aureus may accelerate the progression of HIV disease to AIDS.
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PMID:Staphylococcus aureus colonisation and bacteraemia in persons infected with human immunodeficiency virus: a dynamic interaction with the host. 860 35

To help clinicians better assess and treat functional disabilities in persons with acquired immunodeficiency syndrome (AIDS), the authors estimate empirical relations among biologic and physiologic variables, symptoms, and physical functioning in persons with AIDS. The sample of 305 persons with AIDS for this cross-sectional analysis came from three sites in Boston, Massachusetts: a hospital-based group practice, a human immunodeficiency virus clinic at a city hospital, and a staff-model health maintenance organization. Physical functioning, 10 AIDS-specific symptoms, and mental health were assessed by interview. Clinical diagnoses, comorbidities, health habits such as smoking, laboratory results, and selected medication use were assessed by chart review. Significant predictors of physical functioning P < 0.01, R2 = .58) in a multivariable regression model included energy/fatigue, neurologic symptoms, fever symptoms, a lower hemoglobin level, and current non-pneumonia bacterial infection. Ninety-six percent of the explained variance in physical functioning was accounted for by three symptom complexes: energy/fatigue, neurologic symptoms, and fever symptoms. Significant predictors of energy/fatigue in multivariable models included poorer mental health, lower white blood cell count, longer time since diagnosis, and weight loss (P < 0.01, R2 =.36). Significant predictors of neurologic symptoms included poorer mental health, weight loss, and no zidovudine use (P < 0.001, R2 = .30). Predictors of fever symptoms included poorer mental health, no zidovudine use, weight loss, and history of asthma or chronic obstructive pulmonary disease (P < 0.05, R2 = .25). In conclusion, symptom reports were strong predictors of physical functioning. Poorer mental health and weight loss were correlated consistently with worse symptoms, and not using zidovudine was correlated with worse neurologic and fever symptoms. These variables, and the others the authors identified, may represent mutable determinants of physical functioning in persons with AIDS, and potential targets for specific clinical interventions.
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PMID:Clinical predictors of functioning in persons with acquired immunodeficiency syndrome. 865 26

Tropical pyomyositis (TP), a suppurative disease caused predominantly by Staphylococcus aureus, is responsible for 3% to 4% of surgical admissions in some hospitals in certain tropical countries. This study describes the clinical features of 35 patients with TP (20 males, 15 females; mean +/- SD age 28.3 +/- 14.1 years) admitted to our hospital during a 1-year period and analyzes the causal association between ancylostomiasis, human immunodeficiency virus (HIV) infection, and TP. Concerning the supposed etiologic association between Ancylostoma duodenale infection and TP, among the 35 patients with TP the stool examination of 22 (62.8%) revealed the presence of eggs of A. duodenale. In a control group of 100 asymptomatic subjects the prevalence of ancylostomiasis was 55%. The Odds ration between the two groups is 1.38 (exact 95% confidence limits = 0.59 < OR < 3.34). Furthermore, the pus from all TP abscesses (41 in 35 patients) was carefully collected and examined microscopically, but nematode larvae were not detected in any of the specimens. Hence these results do not support an association between ancylostomiasis and TP. With the aim of correlating TP with HIV infection, I carried out a case-control comparison of HIV seroprevalence among the patients affected by TP and an age- and sex-matched control group of healthy subjects. Eleven patients with TP were HIV antibody-positive (seroprevalence 31.42%), as were two controls (seroprevalence 5.71%). The matched analysis produced a Mantel-Haenszel matched Odds ratio of 5.50 and a maximum likelihood estimate of OR (MLE) of 5.50 (exact 95% confidence limits for MLE: 1.20 < OR < 51.07). Among the 11 patients HIV-seropositive, 9 (81.8%) fulfilled the World Health Organization clinical case definition (CCD) for AIDS, compared with 1 of 24 (4.1%) HIV-negative subjects. The chi-square test for difference in fulfilling the CCD for AIDS between patients with TP seropositive and seronegative result was statistically significant (p < 0.0001). It is concluded that TP is a bacterial infection highly significantly associated with HIV infection and thus must be considered a strong sign of stage III-IV of HIV disease.
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PMID:Tropical pyomyositis. 866 39

Sinusitis in patients with human immunodeficiency virus (HIV) infection usually arises from the same organisms that are infective in the nonimmunosuppressed population. The authors of this article report that optimal antimicrobial treatment and functional endoscopic sinus surgery failed to eradicate sinonasal disease in three of five patients with acquired immunodeficiency syndrome (AIDS) and refractory sinusitis. The sinonasal disease was manifested by congested, edematous, and polypoid mucosa, often with a superimposed bacterial infection from ostial obstruction. After tissue was sent for electron microscopy (EM), the patients were eventually diagnosed with microsporidiosis of the sinonasal cavities. Microsporidia are obligate intracellular protozoans that have been seen in AIDS patients with diarrhea. These protozoans have only recently been identified in sinonasal tissue. Microsporidia are often missed on routine histopathology. The authors present case reports on their five AIDS patients with refractory sinusitis. The management of refractory sinusitis in the HIV-infected population, including mandatory EM of sinonasal tissue, is also discussed.
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PMID:Microsporidian sinusitis in patients with the acquired immunodeficiency syndrome. 869 10

Simple lung function tests have been used to evaluate respiratory symptoms in human immunodeficiency virus (HIV) infected individuals. Abnormalities of simple lung function tests, in particular decreases in the transfer factor of the lung for carbon monoxide (TL,CO) have been described in patients with acquired immune deficiency syndrome (AIDS) who have respiratory disease. Early studies showed marked reductions in TL,CO in patients with pneumocystis pneumonia but other forms of pulmonary infection or neoplasm also resulted in reductions in TL,CO values. Lung function studies in larger numbers of patients have shown reductions in all lung function measurements, particularly in TL,CO. in all categories of HIV disease. The most marked reductions in TL,CO are seen in patients with pneumocystis pneumonia but reductions also occur in pulmonary bacterial infection, tuberculosis and pulmonary Kaposi's sarcoma. TL,CO values improved following recovery from pneumocystis pneumonia but rarely returned to normal. Zidovudine therapy does not contribute to the abnormalities of lung function but smokers generally have worse lung function tests in all categories of HIV disease. The diagnostic usefulness of simple lung function tests is limited. A reduced TL,CO is a highly sensitive index for the presence of pneumonitis (pneumocystis or otherwise) in HIV-infected individuals but lacks the necessary specificity to be a satisfactory diagnostic tool. Simple lung function tests have limitations but have a value as a simple screening test to determine the presence of underlying organic disease in HIV seropositive patients with respiratory symptoms. The presence of a normal TL,CO value makes the presence of pneumonitis unlikely.
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PMID:The lung in HIV infection: can pulmonary function testing help? 876 97

Cytomegalovirus (CMV) is one of the most frequent opportunistic agents that affects HIV positive subjects. The prophylaxis and treatment of cytomegalovirus infection in HIV positive subjects represent difficult and controversial problems. In this study we evaluated efficacy of anti-CMV immunoglobulins (derived from plasma with a high titer of CMV anti-bodies) in primary and in secondary prophylaxis for CMV disease in adults with severe immunodeficiency caused by HIV infection. For primary prophylaxis, in 22 patients with CD4 < 200/mmc enrolled to receive a monthly infusion of intravenous immunoglobulins (IVIG) at 200 mg/kg we observed prophylactic effect for the prevention of CMV and bacterial infections. Concerning secondary prophylaxis, 7 patients with CMV manifestation treated after remission with anti-CMV IVIG at 200 mg/kg every two weeks, had a low frequency of relapse and a good clinical outcome. Because their tolerability, anti-CMV immunoglobulins are an interesting option particularly for the prevention of CMV and bacterial infection in HIV-positive adults in advanced stages of disease.
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PMID:[The use of hyperimmune anti-cytomegalovirus immunoglobulins in HIV infection]. 876 51

A strong association was found to exist between patterns of lymphoid malignancies and socioeconomic status. B-cell lymphomas and T-acute lymphoblastic leukemia are much more prevalent in developing countries where the chances of acquiring infections especially at a younger age are high. B-cell precursor acute lymphatic leukemia, however, are much more prevalent in the Western world. Many infectious agents are associated with lymphatic malignancies. Epstein-Barr virus is involved in African Burkitt's lymphoma, human immunodeficiency virus-related Burkitt's lymphoma, lymphoproliferative syndrome post-transplantation, and Hodgkin's disease. Other infectious agents which may play a role in lymphoproliferative disorders are human immunodeficiency virus in acquired immune deficiency syndrome-associated lymphoma, human T-lymphotropic virus in adult T-cell lymphoma, Helicobacter pylori in mucosa-associated lymphoid tissue lymphoma, theileriosis in lymphoproliferative syndrome in cattle, Avian leukosis virus in chicken bursal lymphoma, and possibly a bacterial infection in immunoproliferative small intestine disease, potentially reversed by antibiotic therapy. The association between infectious agents and hematologic malignancies may be explained by the creation of large populations of activated cells followed by higher occurrences of 'genetic accidents'. This theory may be reinforced in at least some malignancies with the existence of viral proteins which either have complex relationships with key cellular gene products like p53 and Rb which have roles in cell cycle control, or share common motifs with bc1-2, therefore operating as anti-apoptotic elements. Whenever these genes are deranged, cell deoxysibonucleic acid repair or apoptosis are no longer possible, thereby creating a state of genome instability, increased acquisition of mistakes, and increased chances for malignant transformation.
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PMID:Infectious agents and environmental factors in lymphoid malignancies. 881 40


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