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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cytomegalovirus (CMV) is a pathogen causing major disease in an HIV-infected individual. This AIDS-related opportunistic infection results in severe morbidity from chorioretinitis, pneumonitis, encephalitis, adrenalitis, esophagitis, cholangitis, and hepatitis. The author provides a comprehensive overview of CMV infection as seen in adults with HIV disease and related nursing care, and discusses issues related to concerns about occupational exposure among healthcare workers.
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PMID:Nursing care of the adult client with AIDS and cytomegalovirus infection. 131 17

An autopsy case of fulminant hepatitis caused by herpes simplex virus type 1 in a healthy adult is presented. The clinical course was characterized by hepatic failure, disseminated intravascular coagulation and acute renal failure. Many small ulcerations were present in the tongue and tonsils, and there were foci of hemorrhagic necrosis in the liver. Herpes simplex viral antigen was identified in the liver, tonsils, spleen, tongue, pharynx, larynx, esophagus, stomach, intestine, adrenal glands, and lymph nodes with immunohistochemical staining using antibodies to herpes simplex virus type 1. The electron microscopic examination revealed many virions in the hepatocytes. Herpes simplex virus was isolated from the liver, and viral DNA, which had some distinctive features of herpes simplex virus type 1, was examined. We discuss possible reasons for this opportunistic infection occurring in a healthy adult.
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PMID:Disseminated infection of herpes simplex virus with fulminant hepatitis in a healthy adult. A case report. 165 35

Patients with the acquired immune deficiency syndrome (AIDS) frequently develop hepatic dysfunction. Although hepatic injury may indirectly result from malnutrition, hypotension, administered medications, sepsis, or other conditions, the hepatic injury is frequently due to opportunistic hepatic infection, directly related to AIDS. Infection with Mycobacterium avium intracellulare typically occurs in patients with advanced immunocompromise and with systemic symptoms due to widely disseminated infection. In contrast, hepatic tuberculosis often occurs with less advanced immunocompromise. Cytomegaloviral infection may produce a hepatitis. Cytomegaloviral and cryptosporidial infections have been implicated as causes of acalculous cholecystitis and of a secondary sclerosing cholangitis. About 10-20% of patients with AIDS have chronic hepatitis B infection. These patients tend to develop minimal hepatic inflammation and necrosis. The clinical findings in patients with hepatic cryptococcal infection are usually due to concomitant extrahepatic infection. Hepatic histoplasmosis usually develops as part of a widely disseminated infection with systemic symptoms. Hepatic involvement by Kaposi's sarcoma is rarely documented ante mortem because an unguided liver biopsy is an insensitive diagnostic procedure. Patients with non-Hodgkin's lymphoma of the liver typically have lymphadenopathy, hepatomegaly, and systemic symptoms. As a pragmatic approach, patients with liver dysfunction and HIV-related disease should have a sonographic or computerized tomographic examination of the liver. Patients with dilated bile ducts should undergo endoscopic retrograde cholangiopancreatography because opportunistic infection may produce biliary obstruction. Patients with a focal hepatic lesion should be considered for a guided liver biopsy. Patients with a significantly elevated serum alkaline phosphatase level should be considered for a percutaneous liver biopsy. When performed for these indications, liver biopsy will demonstrate a significant disease involving the liver in about 50% of patients with AIDS and in about 25% of patients who are HIV seropositive but who are not known to have AIDS. The clinical impact of a diagnostic biopsy is blunted by a lack of efficacious therapy for many opportunistic infections.
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PMID:Hepatobiliary manifestations of the acquired immune deficiency syndrome. 198 33

The risk of opportunistic infection in the renal transplant patient is due to an interaction between two major factors: the epidemiologic exposures (particularly within the hospital environment) and the net state of immunosuppression. The net state of immunosuppression is determined by the nature, dose, and duration of the immunosuppressive therapy being administered; the presence or absence of granulocytopenia and technical factors that could compromise the primary mucocutaneous barriers to infection; such metabolic factors as uremia, hyperglycemia, and the state of nutrition; and, finally, the immunomodulating effects of such viruses as CMV, the hepatitis viruses, and HIV. The major types of opportunistic infection to which the renal transplant patient is susceptible are the following: the viruses of the herpes group and papovaviruses; bacteria such as L monocytogenes, N asteroides, and Legionella; such fungi as Candida, Aspergillus, C neoformans, and the Mucoraceae; and protozoans such as P carinii, S stercoralis, and T gondii.
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PMID:Opportunistic infections in renal allograft recipients. 305 19

This article sets forth guidelines for health care workers and hospital administrators on the control of acquired immunodeficiency syndrome (AIDS) infection. It is stressed that contact witth blood or bodily fluids by sexual or percutaneous exposure is necessary for transmission. For purposes of infection control, the definition of AIDS should include Kaposi's sarcoma or opportunistic infections without previous immunosuppresive disease or therapy, as well as suspected AIDS. There is no justification for isolating asymptomatic members of high-risk groups. Although special wards for AIDS patients are not necessary from an infection control viewpoint, they may be beneficial in ensuring intensive staff education and providing psychological support for patients. AIDS patients should not share rooms with other immunosuppressed patients, and hospital workers who are pregnant or themselves immunosuppressed should not provide direct patient care for AIDS victims because of concern about cytomegalovirus and other opportunistic infection transmission. Handwashing after patient or body fluid contact is extremely important, and all specimens should be clearly labeled as infectious. Hospital staff who sustain needle stick injuries or mucous membrane exposures to blood or body fluids of AIDS patients should report to the employee health service. Hepatitis prophylaxis should be given if appropriate. Very few cases of AIDS have occurred in health care workers without other risk factors. The epidemiologic data suggest that preventing percutaneous or mucous membrane exposure to blood or body fluids provides adequate protection against the transmission of AIDS in health care settings. Patients with AIDS should not be subjected to isolation procedures that have no scientific basis. Basic is a high level of employee education regarding AIDS and its modes of transmission.
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PMID:AIDS infection control precautions. 397 25

Liver dysfunction occurs after bone marrow transplantation but the relative importance of graft versus host disease and other factors, such as infection, radiation, and drugs, has not been clearly established. We have studied liver status before and after bone marrow transplantation in 43 consecutive patients and have related this to survival and factors that are recognised to cause liver injury. Minor abnormalities of liver tests occurred in 21% of patients before grafting but this did not influence survival or the development of liver disease after transplantation. During the first 50 days after grafting, 83% of patients had abnormal liver tests which were more severe in patients who subsequently died. Alanine transaminase was significantly higher in non-survivors and appeared to predict survival early after transplantation. Only non-survivors developed clinical signs of liver disease. Severe liver disease was always associated with graft versus host disease and atypia of the small bile ducts was the most useful histological marker of hepatic involvement with this disease. Two of the patients with hepatic graft versus host disease also has hepatic veno-occlusive disease and three fatalities had opportunistic infection of the liver, although, in the latter, death was not due primarily to liver dysfunction. Previous hepatitis and androgen therapy could not be implicated as important causes of hepatic damage but chemotherapy for acute leukaemia and conditioning regimens for bone marrow transplantation appear to be the most important factors in the development of hepatic veno-occlusive disease.
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PMID:Liver disease after bone marrow transplantation. 704 84

Sonography provides valuable information about diffuse liver disease. This article reviews the normal features of hepatic parenchyma as well as the sonographic findings that characterize important pathological conditions. Included are hepatitis, opportunistic infection, diffuse metastasis, fatty liver, hepatic fibrosis, and cirrhosis.
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PMID:Sonographic diagnosis of diffuse liver disease. 771 84

Cytomegalovirus (CMV) infection is the most frequent systemic viral opportunistic infection in AIDS, occurring in almost 40% of patients, at a stage of profound immunodeficiency, with a CD4 cell count lower than 50/microL. The most frequent localizations are retinal and gastrointestinal. Diagnosis of retinis, which can be totally asymptomatic, is based on fundus examination, which should be performed regularly in patients with AIDS and/or low CD4 count. Diagnosis of colitis, as of other rare manifestation (oesophagitis, hepatitis, encephalitis, myeloradiculitis, pneumopathy), relies on the association of suggestive clinical symptoms and CMV inclusions in biopsy specimens and/or CMV positive culture. The 2 drugs available for treatment of CMV disease, ganciclovir and foscarnet, are administered by intravenous route, with 2 infusions per day for induction therapy (usually 2 to 3 weeks), then once a day as lifelong maintenance therapy, to lessen or delay recurrences. Active drugs which could be given orally, combination of 2 drugs, new potent drugs and the development of prophylaxis in at-risk patients should help to improve the prognosis of CMV infection in AIDS.
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PMID:[Cytomegalovirus infections in AIDS]. 775 12

Recent developments in medical technology have caused a great change in infectious diseases, as characterized by epidemics of antibiotics-resistant bacteria, opportunistic infection in compromised hosts, and blood-borne viral infections such as hepatitis virus and human immunodeficiency virus. In the diagnosis of such new aspects of infectious diseases, conventional immunological, culture, and microscopical techniques are not always practical. By contrast, evaluation of infectious agents using molecular biological technology frequently offers the rapid, most accurate and sensitive method of diagnosis. Amplification methods are particularly attractive for the detection of small numbers of microorganisms, as in latent conditions, or for the fastest identification of the pathogen without laborious isolation. For introduction of the tests into routine procedures, their standardization as well as simplicity and low cost are required. Gene level diagnostics should be applied appropriately to management of infectious diseases along with the conventional techniques, while further roles of the tests must be determined, on the basis of the molecular elucidation of infectious diseases.
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PMID:[Gene level diagnostics of infectious diseases]. 805 3

The paper describes events that in the last fifteen years, have led to the identification of the aetiological agents of three widely known diseases: cat scratch disease, erythema infectiosum and exanthem subitum. The particular features of Afipia felis and Rochalimaea, Parvovirus B 19 and Herpesvirus 6 are presented. The paternity of new diseases (i.e. bacillary angiomatosis, bacillary peliosis hepatitis, LES-like syndrome, chronic fatigue syndrome, petechial glove and sock syndrome, etc.) has also been attributed to some of these pathogens as has the paternity of some older ones (i.e. aplastic crisis, erythroblastosis fetalis, trench fever, hepatitis, opportunistic infection, etc.). It has been argued that the same pathogen can cause different diseases depending on the immunogenic state of the subject. To date, persisting difficulties in isolating the pathogen or differentiating between latent or active infection, still in some cases raises doubts concerning the attribution of the disease to a specific agent. New immunological or molecular techniques, allowing the direct detection of in vivo replication, are still needed in order to establish a sure connection between some of these agents and some of these diseases. Progress here will both give more accurate data about the epidemiology of some diseases and allow us to apply more appropriate treatment and prevention techniques.
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PMID:New pathogens, and diseases old and new. I) Afipia felis and Rochalimaea. II) Parvovirus B 19. III) herpesvirus 6. 871 Apr 8


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