Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the diagnostic utility, value and potential risk of fine needle aspiration biopsy of spleen (sFNAB) in patients with splenomegaly in pyrexia of unknown origin (PUO), a retrospective analysis of medical records and cytological material of 31 patients on whom FNAB was performed between April 1994 and October 1997 was done. The patients were HIV- and presented with PUO. All other relevant investigations were negative. The spleen was either palpable or detected to have space-occupying lesions on ultrasonography (USG). The splenic aspirates showed tuberculosis in 11 patients (35.4%) and inconclusive or reactive changes in nine patients (25.8%). One case out of this group proved to be Kaposi's sarcoma on autopsy. The other diseases encountered were leishmaniasis (n = 3), non-Hodgkin's lymphoma (n = 4), fungal infections (n = 2), Hodgkin's lymphoma (n = 1). The patients who were diagnosed as having tuberculosis had epithelioid cells, giant cells, necrosis and inflammatory cells in various combinations. AFB positivity was 63.6%. The other cases which showed granulomas but no AFB were diagnosed on empirical grounds and all responded to the anti-tuberculosis therapy. No complications were encountered with the procedure. Therefore the authors conclude that sFNAB is rewarding in patients where all other non-invasive modalities of diagnosis have failed.
 ...
PMID:Fine needle aspiration biopsy of the spleen in pyrexia of unknown origin. 1039 68

A prospective study was conducted to determine the etiology, clinical features, and outcome in a series of 32 consecutively enrolled HIV-infected patients with prolonged fever in whom high resolution (7.5 Mhz) sonography revealed multiple splenic microabscesses. Conventional (3.5 Mhz) sonography showed no splenic abnormalities in any patients. The diagnoses were: tuberculosis (14), visceral leishmaniasis (7), disseminated Mycobacterium avium complex infection (5), Salmonella spp. bacteremia (2), lymphoma (2), disseminated Rhodococcus equi infection (1), disseminated Candida krusei infection (1) and Pneumocystis carinii pneumonia (1). Twenty-eight patients were followed up for six months and four were lost to follow-up. In 16 patients with a clinical cure and microbiological eradication, the findings on follow-up high resolution sonography were normal, and in two patients the microabscesses persisted; ten patients died. In conclusion, the findings suggest splenic microabscesses may be a frequent condition in HIV-infected patients with prolonged fever, being an unspecific manifestation of the opportunistic diseases causing fever of unknown origin in this population. They cannot be detected by conventional abdominal sonography, whereas high resolution sonography is a useful technique for their detection and follow-up.
 ...
PMID:Etiology, clinical features and outcome of splenic microabscesses in HIV-infected patients with prolonged fever. 1042 Oct 38

Over a 5 month period (October 1996 to February 1997), a rotating company of 146 servicemen belonging to the Navy Airborne 6th Regiment were assigned along the Maroni River in French Guyana. During this mission, the medical personnel treated 387 local residents. Etiologies comprised 51 malaria attacks including 46 involving Plasmodium falciparum and 4 rattlesnake envenomations. The most common cause of consultation by military personnel was mycotic and staphylococcal skin infections, but 5 cases involving poor acclimatization were treated during the hot and dry season. Seven malaria attacks involving Plasmodium falciparum including 2 that were severe occurred despite prophylaxis using chloroquine-proguanil. Treatment with halofantrine was successful in all but one case which required combined chemotherapy using quinine and doxycycline. Five cases of cutaneous leishmaniasis were observed in subjects involved in jungle training. No case of HIV infection was detected upon returning home since most personnel either followed the recommendation to abstain from sex (51 p. 100) or used a condom (90 p. 100 of personnel who had sexual relations). These data illustrate the health risks for mainland French nationals in the region of the Maroni River and underline the need for preventive measures and education.
 ...
PMID:[Health assessments of a military company stationed on the Maroni River in French Guiana]. 1047 89

Tests on a panel of 421 serum samples from Ethiopia and 11 from Europe with the direct agglutination test (DAT) and freeze-dried antigen (Leishmania donovani 1S) showed that a cut-off titre of 1:200 or 1:400 could be employed. Using a cut-off titre of 1:400, 181 (88.3%) of 205 serum samples from visceral leishmaniasis (VL) patients tested positive, as did 5 (13.9%) of 36 sera from patients with localized cutaneous leishmaniasis, 5 (71.4%) sera from 7 patients with diffuse cutaneous leishmaniasis and 8 (89.9%) sera from 9 HIV-positive VL patients. We also found that 19 (57.6%) sera from 33 treated VL patients were still positive in the DAT at 1.5 to 5 years after treatment.
 ...
PMID:Evaluation of the direct agglutination test (DAT) using freeze-dried antigen for the detection of anti-Leishmania antibodies in stored sera from various patient groups in Ethiopia. 1049 58

Two HIV infected patients with visceral leishmaniasis and unusual cutaneous lesions are described. The first patient developed linear brown macules containing Leishmania parasites on the fingers and palms of the hands. This patient never received highly active antiretroviral treatment and the visceral leishmaniasis could not be cured even with liposomal amphotericin. In the second patient, Leishmania parasites were present in a skin biopsy of a fibrous histiocytoma. After completing visceral leishmaniasis treatment, a discrete elevation of one of his tattoos was seen. A biopsy specimen of this tattoo revealed Leishmania amastigotes. In this patient the visceral leishmaniasis was finally cured with meglumine antimoniate, followed by pentacarinat isothianate as maintenance therapy in conjunction with highly active antiretroviral treatment.
 ...
PMID:Unusual cutaneous lesions in two patients with visceral leishmaniasis and HIV infection. 1053 67

Although not considered as indicative of AIDS, leishmaniasis presents a number of epidemiologic and clinical features that promote opportunistic infection in HIV patients. Accurate assessment of the incidence of this type of co-infection is difficult due to underestimation in endemic areas such as Africa and Asia. In these areas the WHO estimates that 2 to 9 p. 100 of HIV patients will develop leishmaniasis/HIV co-infection which could become a major concern. The characteristics of this co-infection have been documented. It is observed in adults between 20 and 40 years of age with a strong male sex bias. The visceral form is most frequent. Manifestations are similar to those observed in immunocompetent subjects but with the possibility of asymptomatic and low-grade forms (10 p. 100) and unusual locations suggesting multiorgan spreading in absence of host immune response. In addition to the time-tested standard procedures for diagnosis of parasitic disease, new serologic tests and genomic amplification are now available. Pentavalent antimonials have long been considered as the treatment of choice but they are not always effective and can have untoward effects. Amphotericine B especially in the liposomal form is a good alternative. The particularly high incidence of recurrence suggests that follow-up may be indicated but the modalities of prophylaxis have yet to be defined.
 ...
PMID:[Leishmaniasis and human immunodeficiency virus: an emerging co-infection?]. 1054 96

Visceral leishmaniasis is an infectious disease that occurs only rarely in recipients of solid organ grafts but is associated with an elevated mortality rate despite proper treatment. We report five cases diagnosed in our hospital. All the patients were men aged 30 to 60 years who had undergone kidney transplantation (3 patients), heart transplantation (1), or liver transplantation (1). Three of the patients died, one had multiple recurrences, and one developed post-kala-azar cutaneous leishmaniasis. We review the clinical features, treatments, and outcomes of 26 previously reported cases, pointing out the lower cure rate associated with human immunodeficiency virus infection.
 ...
PMID:Visceral leishmaniasis (kala-azar) in solid organ transplantation: report of five cases and review. 1058 10

Visceral leishmaniasis is a protozoan infection that may complicate the course of patients with human immunodeficiency virus (HIV). Dermatofibroma is a cutaneous fibrohistiocytic lesion considered neoplastic by some authors and inflammatory by others. Eruptive dermatofibromas have been described in patients with HIV infection or with other altered immunity situations. We present the case of a 32-year-old, HIV-positive man with visceral leishmaniasis who complained of the appearance of a cutaneous lesion in the leg formed by the coexistence of dermatofibroma and Leishmania parasitic colonization. As far as we know, this type of association has not been reported previously. We consider that the dermatofibroma could have developed as an unusual form of fibrohistiocytic reaction to leishmania. From a practical approach, we recommend the search of leishmaniasis in dermatofibroma in immunosuppressed patients.
 ...
PMID:Dermatofibroma parasitized by Leishmania in HIV infection: a new morphologic expression of dermal Kala Azar in an immunodepressed patient. 1059 43

Neopterin, a product of gamma-interferon-activated macrophages, was measured in sera from 28 patients (12 patients with cutaneous leishmaniasis and 16 patients with visceral leishmaniasis) to determine the utility as a marker of disease activity and therapeutic efficacy. Patients originated from Kenya (n=5) and from the Academic Medical Center, Amsterdam, The Netherlands (n=23). In seven patients follow-up sera after treatment were available. Two patients at the time of diagnosis of visceral leishmaniasis were co-infected with HIV. The 12 patients with cutaneous leishmaniasis had serum neopterin levels below the upper limit of the normal range. All 16 patients with visceral leishmaniasis had elevated levels of serum neopterin before treatment. In six out of seven patients with visceral leishmaniasis followed during treatment neopterin levels decreased to values below the upper limit of the normal range (10 nmol l(-1)). Sequential measurements of serum neopterin levels may be useful for monitoring therapeutic efficacy in patients with visceral leishmaniasis.
 ...
PMID:Serum neopterin concentrations during treatment of leishmaniasis: useful as test of cure? 1061 87

Immunosuppression is associated with the occurrence of a large variety of infections, several of them due to opportunistic protozoa. The parasitic protozoa of the family Trypanosomatidae vary greatly in their importance as potential opportunistic pathogens. African trypanosomiasis is no more common nor severe during AIDS. The situation with Chagas' disease, however, is much different. Although the process is not clearly understood, there appears to be a reactivation of Trypanosoma cruzi infection, which can lead to severe meningoencephalitis. In persons with AIDS, leishmaniasis is often exacerbated, particularly Leishmania infantum, which causes visceral leishmaniasis in southern Europe. Since 1990, 1,616 cases of visceral leishmaniasis/HIV co-infection have been reported, mainly from southern Europe, and particularly from Spain, southern France, and Italy. The co-infected patients are primarily young adults and belong to the risk group of intravenous drug users. Isoenzymatic identification of 272 isolates showed 18 different L. infantum zymodemes, of which 10 represent new zymodemes hitherto found only during HIV co-infection. New foci of co-infection are emerging in various parts of the world, including Brazil and East Africa. Moreover, since 1995, non-human monoxenous trypanosomatids have been found in AIDS patients, causing both diffuse cutaneous lesions and visceral infections. In countries where visceral leishmaniasis is endemic, particularly in southern Europe, immunosuppressive treatments for organ transplants or malignant diseases often result either in reactivation of asymptomatic visceral leishmaniasis or in facilitation of new infections.
 ...
PMID:Leishmania, Trypanosoma and monoxenous trypanosomatids as emerging opportunistic agents. 1065 Dec 94


<< Previous 1 2 3 4 5 6 7 8 9 10