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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The literature contains reports documenting a foodborne etiology for bacterial infections caused by Salmonella spp, Listeria monocytogenes, Campylobacter jejuni, and Vibrio spp in individuals with the human immunodeficiency virus (HIV). The incidence of these infections and the life-threatening complications that result are elevated in people with HIV infection. We present practical recommendations to prevent foodborne illnesses and the resulting complications, including gastroenteritis, bacteremia, meningitis, and death. We suggest that patients with HIV infection be counseled to avoid foods at high risk for harboring bacterial pathogens and to use careful sanitary practices in food preparation.
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PMID:Foodborne bacterial infections in individuals with the human immunodeficiency virus. 811 77

We present a case of human immunodeficiency virus (HIV) infection complicated by Streptococcus bovis meningitis and bacteremia and severe Strongyloides stercoralis colitis. The association between S. bovis infection and strongyloidiasis has not been described previously. This case highlights the importance of searching for larvae of S. stercoralis as part of the evaluation of the gastrointestinal tract of patients with bacteremia or meningitis due to certain enteric organisms. The role of HIV infection in the development of severe S. stercoralis colitis in association with S. bovis bacteremia and meningitis is unclear.
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PMID:Streptococcus bovis bacteremia and meningitis associated with Strongyloides stercoralis colitis in a patient infected with human immunodeficiency virus. 816 38

Treatment of Tuberculosis. 1. A 6-mo regimen consisting of isoniazid, rifampin, and pyrazinamide given for 2 mo followed by isoniazid and rifampin for 4 mo is the preferred treatment for patients with fully susceptible organisms who adhere to treatment. Ethambutol (or streptomycin in children too young to be monitored for visual acuity) should be included in the initial regimen until the results of drug susceptibility studies are available, unless there is little possibility of drug resistance (i.e., there is less than 4% primary resistance to isoniazid in the community, and the patient has had no previous treatment with antituberculosis medications, is not from a country with a high prevalence of drug resistance, and has no known exposure to a drug-resistant case). This four-drug, 6-mo regimen is effective even when the infecting organism is resistant to INH. This recommendation applies to both HIV-infected and uninfected persons. However, in the presence of HIV infection it is critically important to assess the clinical and bacteriologic response. If there is evidence of a slow or suboptimal response, therapy should be prolonged as judged on a case by case basis. 2. Alternatively, a 9-mo regimen of isoniazid and rifampin is acceptable for persons who cannot or should not take pyrazinamide. Ethambutol (or streptomycin in children too young to be monitored for visual acuity) should also be included until the results of drug susceptibility studies are available, unless there is little possibility of drug resistance (see Section 1 above). If INH resistance is demonstrated, rifampin and ethambutol should be continued for a minimum of 12 mo. 3. Consideration should be given to treating all patients with directly observed therapy (DOT). 4. Multiple-drug-resistant tuberculosis (i.e., resistance to at least isoniazid and rifampin) presents difficult treatment problems. Treatment must be individualized and based on susceptibility studies. In such cases, consultation with an expert in tuberculosis is recommended. 5. Children should be managed in essentially the same ways as adults using appropriately adjusted doses of the drugs. This document addresses specific important differences between the management of adults and children. 6. Extrapulmonary tuberculosis should be managed according to the principles and with the drug regimens outlined for pulmonary tuberculosis, except for children who have miliary tuberculosis, bone/joint tuberculosis, or tuberculous meningitis who should receive a minimum of 12 mo of therapy.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Treatment of tuberculosis and tuberculosis infection in adults and children. American Thoracic Society and The Centers for Disease Control and Prevention. 759 59

The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypointense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered.
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PMID:Central nervous system tuberculosis: MRI. 818 66

Streptococcus pneumoniae is a leading cause of morbidity and mortality, mainly in children, elders and individuals with AIDS or AIDS-related complex, being a frequent bacterial cause of pneumonia, otitis media, sinusitis, bacteremia and meningitis. Polyvalent pneumococcal capsular polysaccharide vaccines contain the 23 most common pneumococcal serotypes causative of pneumococcal infection in several countries. Public Health Service Advisory Committee on Immunization Practice of the Centers for Disease Control (CDC) does not recommend the polyvalent pneumococcal vaccine for general public. However, several investigators have recommended its employment for special population at high risk, such as for HIV infection, who can be at enhanced risk for systemic pneumococcal disease. The objective of the present literature review is to relate the importance of studied different types of polyvalent pneumococcal vaccines as well as their immunological properties in the vaccinated people.
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PMID:Polyvalent pneumococcal polysaccharide vaccines; a review of the literature. 824 4

Fungal infections account for a large number of AIDS-index diagnoses and complicate the course of most patients with HIV disease. Infection with Cryptococcus neoformans is the most commonly encountered deep-seated fungal infection in AIDS and represents a major threat to HIV-infected people worldwide. Although most patients with cryptococcosis present with meningitis, pulmonary disease may occasionally dominate the clinical picture. Treatment of symptomatic pulmonary cryptococcosis remains amphotericin-B with or without 5-flucytosine. The toxicity and difficulty of administration of amphotericin-B has engendered interest in treatment alternatives with the new triazoles. As HIV infection has become more common in the American heartland, it has overlapped areas endemic for Histoplasma capsulatum, Coccidioides immitis, and Blastomycosis dermatitidis. Disease from these deep-seated fungal pathogens, whether from de novo exposure or reactivation, has protean manifestations. Common to all is a protracted, febrile, wasting illness, with or without respiratory symptoms. Treatment of choice for all these infections remains amphotericin-B, followed by lifelong-maintenance therapy with a triazole. In this article I review the microbiology, epidemiology, presentation, diagnosis, and treatment of AIDS-associated deep-seated fungal infections.
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PMID:Pulmonary fungal infections in HIV-infected persons. 827 79

The Epidemic Section at the Oslo City Department of Health and Environment, is responsible for monitoring communicable diseases in Oslo. We have registered an increase in the number of severe cases of pneumococcal disease with bacteremia, sepsis and meningitis. Fifty-two cases of invasive pneumococcal disease occurred in Oslo in 1992. There are no available data on the HIV-status of these patients. Streptococcus pneumoniae is frequently found as part of the normal flora of the upper respiratory tract, and is an important pathogen for patients infected with HIV. We discuss indications for use of pneumococcal vaccine, and recommend earlier and more extensive use of this vaccine in HIV-infected persons in Norway.
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PMID:[Pneumococcal vaccine recommended for HIV-infected individuals]. 832 55

Cryptococcosis is the fourth cause of infection of the Central Nervous System in patients with infection by HIV. Despite this fact, the series published in our country are referred to a limited number of cases. We describe the most relevant characteristics of 13 patients with meningitis by Cryptococcus neoformans. We used as inclusion criteria a positive culture of the Cephalorhachidian Fluid (CRF). We observed a significant reduction in the levels of CD4 lymphocytes in all patients, the absence of meningitic syndrome in more than 50% cases (8/13) and a normal CRF cytobiochemistry in three patients. The thoracic radiography was normal in all cases but two, although the cryptococcus was cultured in a transbronchial biopsia of a patient with normal thoracic radiography. The Computerized Axial Tomography showed frequent alterations (5/13). Eight patients were treated with amphotericin B (0.5 mg/kg/d) and five with fluconazol (400 mg/day). Despite following a maintenance therapy with fluconazol (200 mg/d), we had two cases of recurrence in the group previously treated with fluconazol. The level of leukocytes in the CRF was the only prognosis factor (p < 0.05). Five patients died during their first hospitalization due to causes related to the infection by cryptococcus. New therapeutical guidelines are needed in order to improve the prognosis of these patients.
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PMID:[Cryptococcosis of the central nervous system and infection by HIV. Clinical-evolutive characteristics in 13 cases]. 833 2

Neurologic illness related to HIV-1 infection can involve the entire neuraxis and result in a wide range of neurologic syndromes. This article reviews intracerebral mass lesions, meningitis, myelopathy, peripheral neuropathy, and occupational exposure to HIV-1.
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PMID:Neurologic critical care in patients with human immunodeficiency virus 1 infection. 842 16

We review four different aspects of tuberculosis (TB), a disease which is making a comeback as a focus of medical attention. The diagnosis of TB in HIV infected individuals can be very challenging for the clinician and an increased number of side effects complicates treatment. Updated information in this area appears necessary for physicians who are in charge of HIV-infected patients. The "cursed duet" of TB and HIV infection is also responsible for the increase of TB in subsaharan Africa. Recent data are discussed in relation to this issue. Another problem for developing countries is the diagnosis and treatment of children's TB, which involves particular features as compared to the adult form of the disease. Finally, new diagnostic methods are now available from the laboratory. The detection of mycobacteria with the polymerase chain reaction has proven very useful in the diagnosis of tuberculous meningitis. Detection of tuberculostearic acid and mycobacterial antigen also represent important advances. The role of these techniques in the diagnosis of TB forms other than meningitis will need to be defined in the near future.
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PMID:[Tuberculosis 1992: current clinical aspects, epidemiology and diagnosis]. 843 33


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