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

Systemic fungal infections are diseases of increasing incidence in immunocompromised patients. They are an important cause of morbidity and mortality in patients with severe granulocytopenia caused by hematological malignancies or high-dose corticosteroid treatments. Systemic candidiasis is usually attributed to colonization of the patient's digestive mucosa or central venous/peritoneal catheters by endogenous Candida spp. Esophageal candidiasis can be a serious problem in predisposed individuals, and it can be the first opportunistic infection suggesting overt AIDS in HIV-seropositive patients. The aim of this review is to assess the epidemiology of alimentary tract mycoses in "at risk" groups because of iatrogenous or pathological reasons, such as in-patients undergoing solid organ and bone marrow transplantation, peritoneal dialysis and enteral/parenteral nutrition and in HIV infected patients.
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PMID:Epidemiology of digestive tract mycoses in immunocompromised patients--a review. 212 96

Human cytomegalovirus (CMV) has several possible roles in the pathogenesis of AIDS. CMV causes a number of clinical syndromes, including retinitis, pneumonitis, and gastroenteritis in patients infected with human immunodeficiency virus type 1 (HIV-1). In addition, CMV may potentiate the cellular immunodeficiency observed in patients with HIV infection either directly or through enhancement of HIV replication. Finally, CMV may predispose the host to bacterial or fungal infection by compromising the integrity of mucosal barriers to infection. Therapy with ganciclovir for CMV infection may result in a decrease in morbidity related to the virus, but problems with drug toxicity and resistance to the agent mandate the development of additional therapeutic approaches.
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PMID:Cytomegalovirus in the setting of infection with human immunodeficiency virus. 164 83

The history of 29-year-old male from Surinam with antibodies to HIV-1 and long-lasting fever, lymphadenopathy, pain in the right upper abdomen and a granulomatous hepatitis is described. The patient suffered from disseminated histoplasmosis, a fungal disease rare in The Netherlands, which is the indicator disease for the diagnosis of AIDS (CDC-IVCI). It is stressed that in seropositive patients coming from endemic areas, including Surinam, the possibility of this disease should be considered.
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PMID:[Histoplasma capsulatum infection, a manifestation of AIDS unusual for The Netherlands]. 221 72

We report a case of recalcitrant generalized cutaneous polydermatophyte and Candida infection in an AIDS patient who responded very poorly to topical, oral, and intravenous therapy. The patient died of respiratory arrest secondary to pneumonia 14 months after a cutaneous fungal infection developed and 12 months after AIDS was diagnosed. Extensive cutaneous fungal infections refractory to treatment may be a presenting sign of HIV infection.
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PMID:Disseminated cutaneous fungal infection and AIDS. 232 22

From January 1988-September 1989, dental practitioners performed a comprehensive oral examination on 83 HIV positive patients at the Department of Infectious Diseases, University Clinic of Internal Medicine in Kinshasa, Zaire for a study on prevalence and clinical aspects of oral lesions associated with HIV infection. Women comprised 55.5% of these AIDS patients. They all had oral lesions: 94% fungal, 33% bacterial, 23% viral, 14% unknown origin, and 12% neoplasms. The majority of these oral lesions developed in 31-40 year olds. Further, the 21-30 year olds were more likely to have bacterial infections, especially aggressive periodontitis. Fungal infections occurred most often on the lips, palate, and tongue, while viral infections occurred mainly on the tongue. Kaposi's sarcoma only afflicted the palate. Pseudomembranous candidiasis was the leading fungal infection (32% of all oral lesions) then atrophic (22.8%) and hyperplastic (6%) types. 17% and 16% of all lesions included these bacterial infections: aggressive periodontitis and necrotizing gingivitis respectively. the leading viral infection was hairy leukoplakia (14%) followed by leukoplakia (8%), and herpetic stomatitis (4%). The unknown lesions included ulcers (12%) and a swollen salivary gland )2%). 12% of the examined AIDS patients, mostly 31-50 year olds, had oral Kaposi's sarcoma. They also had it on other parts of the body. Since HIV prevalence in Zaire ranges between 3-8%, all dentists should be cognizant of oral manifestations of HIV which may indeed be the 1st clinical indications of HIV. They should refer any patients with such lesions to a health facility with AIDS specialists for diagnosis and care.
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PMID:Oral manifestations of AIDS in a heterosexual population in a Zaire hospital. 235 42

Alpha-2a-recombinant interferon (Roferon A) was given subcutaneously in a dose of 3 mega units twice weekly for 15-18 months to 14 HIV-antibody-positive, p24-antigen-negative men with minimal HIV-related disease. Interferon was well-tolerated and safe. Although there was either improvement or lack of deterioration initially in 22 out of 26 HIV disease markers, including lymphadenopathy, thrombocytopenic purpura and nail fungal infection, there were 11 instances of HIV disease indicators appearing during the study. At 15 months, six patients were withdrawn from the study because of clinical and immunological deterioration.
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PMID:An open study of interferon in HIV-antibody-positive men. 257 30

In a 33-year-old HIV-positive homosexual male suffering from unexplained headache, cryptococcosis was diagnosed in a progressive secondary stage. After treatment with the standard combination therapy of amphotericin B + flucytosine for 34 d, the patient was clinically symptom-free and discharged, upon his own request, from the hospital. He remained under ambulatory mycological control. After an interval of 65 d during which the urine had been free from Cryptococcus neoformans (Cr.n.), the fungus could not be isolated from urine but 3 X 10(5) CFUs/ml were found in the seminal fluid. Andrologically, teratospermia and hyposemia were present. There were no clinical signs in the genitourinary tract including the prostate. The significance of ecological niches for Cr.n. colonization of the genitourinary tract after antimycotic therapy is discussed. In such cases, in addition to cultural examination of urine for Cr.n. by the membrane filtration technique (MFT) and Staib agar, an additional cultural examination of seminal fluid is recommended. It is also proposed to pay more attention to Cr.n. in andrological examinations. Special regard should be given to a possible occurrence of Cr.n. in the seminal fluid of AIDS patients. In cytology of the seminal fluid, use of the Giemsa stain is unsuitable for the purpose of Cr.n. detection. For this reason, it should be supplemented by PAS staining.
Mycoses 1989 Apr
PMID:Cryptococcus neoformans in the seminal fluid of an AIDS patient. A contribution to the clinical course of cryptococcosis. 266 52

We present two cases of paracoccidioidomycosis, one occurring in an AIDS patient and the other in an HIV infected man. This is the first report of such association. The first patient, which was already followed for HIV infection (group IV-A) presented with high fever and hepatosplenomegaly. Plain X-ray, ultrasound and CT-scan of the abdomen showed solid nodules in the spleen, some of them with calcification. Both the direct smear and the culture of a bone marrow aspiration revealed Paracoccidioides brasiliensis. The patient died of acute disseminated Paracoccidioidomycosis. The second patient, a man anti-HIV seropositive presented with a mass on the right lower abdomen and inguinal region. A biopsy of the mass showed the association of Hodgkin's disease of the mixed cellularity type and paracoccidioidomycosis. With the expanding AIDS epidemic we believe this report emphasizes the need to consider Paracoccidioidomycosis in HIV infected persons in countries where this mycosis is endemic. We also suggest the inclusion of Paracoccidioidomycosis as a potential opportunistic infection in these areas.
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PMID:[Paracoccidioidomycosis and infection by the human immunodeficiency virus]. 269 Mar 7

Oral candidosis is a very frequent diseased state occurring mainly together with severe underlying disease. Clinical manifestation is variable. One can distinguish between oral thrush, denture stomatitis, angular cheilitis, leukoplakia and midline glossitis. Nowadays oral candidosis is also important in connection with HIV-infection. Here the clinical spectrum does not seem to be totally different. Apart from oral thrush (or pseudomembraneous type) a chronic atrophic type, a chronic hyperplastic type, papillary hyperplasia and angular cheilitis are distinguished. Oral candidosis is the most frequent opportunistic infection in HIV-infected patients. Frequency of overt disease is linked to the T4/T8 ratio. In patients with AIDS-related complex oral candidosis seems to be indicative of rapid progression. Candida albicans is the prevailing microorganism. There is, however, a change of biotypes during the course of HIV-infection. There seems to be a selection of certain phenotypes as can be judged from the increasing resistance to 5-fluorocytosine.
Mycoses 1989
PMID:Clinical spectrum of oral candidosis and its role in HIV-infected patients. 270 Feb 17

Oral and esophageal candidosis are very common in HIV-infected patients. Due to the lack of efficacy of topical antimycotics in advanced stages of HIV-infection oral azoles are mainly used for treatment. Azoles most often used are ketoconazole and fluconazole. While Candida albicans clearly is the most frequently encountered yeast before and after treatment other species can be found somewhat less frequently after treatment. This especially applies to Candida glabrata. Candida spp. other than C. albicans obviously may cause manifest oral candidosis. This shift of microbes deserves the more interest as they are less susceptible to azole drugs.
Mycoses 1989
PMID:Change of causative organisms under antifungal treatment in immunosuppressed patients with HIV-infections. 270 Feb 22


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