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)

We report on a 32-year-old male patient with advanced acquired immunodeficiency syndrome (AIDS), who had severe candidiasis of the gastrointestinal tract. Treatment with fluconazole, 200 mg/day, was introduced. After oral intake of fluconazole over 5 months itraconazole 200 mg/day was given for 1 month. However, fungal infection still persisted. The antifungal activity of fluconazole, itraconazole and ketoconazole against Candida albicans was evaluated by means of the microdilution test by determining the 90% inhibitory concentration of each drugs. A high minimal inhibitory concentration (MIC) was detected for fluconazole (50 micrograms/ml) revealing fluconazole resistance. The susceptibility to itraconazole was borderline (MIC 0.125 micrograms/ml) and that to ketoconazole was markedly lowered (MIC 0.25 micrograms/ml). Plasma levels of itraconazole were also found to be lowered. In HIV patients the gastrointestinal absorption of azole derivatives is often reduced. Therefore, the clinical resistance of Candida albicans to itraconazole can be explained by reduced susceptibility after azole therapy and also by the decreased absorption of the drug in HIV patients.
 ...
PMID:[Clinical fluconazole and itraconazole resistance of oro-gastrointestinal candidiasis in a patient with AIDS]. 967 78

Opportunistic infections are, together with some specific neoplasias, the main problem facing the physician when treating patients affected with AIDS. In fact complications arising from infections correlated to the syndrome are a major factor in both morbidity and mortality. In recent years, thanks to improvements in diagnostic techniques, it has become possible to diagnose opportunistic infections much earlier than in the past, and the use of new antiviral and antifungal molecules has provided the means for more effective treatment, with lower toxicity. In the present study we examine the clinical and diagnostic implications of opportunistic mycotic pathologies, in particular candidiasis of the oral mucosa, which occurs frequently in HIV-positive and AIDS patients. In determining the clinical, diagnostic and therapeutic aspects of mycosis of the oral cavity, close collaboration with the pathologist is crucial importance to the stomatologist, as well as objective clinical examination and microbiological culture tests.
 ...
PMID:[HIV infection and opportunistic pathology: the etiopathogenetic considerations and clinico-diagnostic aspects in candidiasis of the oral mucosa]. 892 78

A case of disseminated cryptococcosis in an HIV-negative patient presenting with cutaneous lesions is described for the first time in Egypt. The patient, a 16-year-old male, presented with cough, expectoration, loss of weight, and cutaneous lesions, mainly on the face and trunk. The lesions consisted of vegetating crusted plaques discharging purulent to sanguinous fluid and flattened, shiny, erythematous to brownish plaques. Anorexia, headache and personality changes soon followed. Histopathological examination of lesions was highly suggestive of a deep mycosis, particularly cryptococcosis. The fulminant disease advanced with central nervous system involvement. The progression was not arrested when systemic antifungal therapy was administered late in the disease course. Pathological examination of lungs, liver, pancreas and spleen revealed disseminated infection with no evidence of other underlying pathology. Disseminated cryptococcosis is a morbid infection, rare in an area where heightened awareness and raised index of suspicion will surely allow earlier diagnosis, management and better prognosis.
 ...
PMID:Disseminated cryptococcosis with cutaneous lesions. 893 33

Fungal infections are of minor importance in general practice. With the possible exception of cryptococcosis in HIV-infected patients deep fungal infections are rarely seen in ambulatory medicine. Some exceptions are discussed. Candida spp. are normally found on the surfaces of the gastrointestinal and genital tract. The documentation of yeast from these sites is therefore not an indication for antifungal therapy. Esophagitis oral or vaginal thrush should however be treated promptly with oral fluconazole. Cutaneous mycoses are best treated topically or if too extensive with itraconazole or terbinafine. Treatment of nail infection, if treatment is warranted at all is best treated with terbinafine. Any attempts to attribute uncharacteristic complaints to an intestinal colonization with yeasts or nutritional fungal toxins lacks a scientific background. The practice to diagnose from blood films obscure fungal infections is quackery at best.
 ...
PMID:[Fungal infections in primary care]. 896 12

Oral candidiasis is a common fungal infection in patients infected with the human immunodeficiency virus (HIV). Although rare at the time of primary HIV infection, it is frequently found throughout the asymptomatic phase and is predictive of progressive immunodeficiency. However, the precise immune defect which results in outgrowth of commensal Candida albicans in HIV infection has not been identified. Mice infected with the Du5H(G6T2) mixture of mouse leukemia viruses develop a syndrome, designated murine AIDS (MAIDS), that has many of the immune abnormalities found in HIV infection. Retrovirus-infected C57BL/6 mice were examined for their ability to resist the development of oral candidiasis from the carrier state established after a self-limiting acute infection and to clear a subsequent secondary inoculum of oral C. albicans. Most of the mice orally colonized with C. albicans and then inoculated with the retrovirus mixture maintained a low-level oral carriage of C. albicans, while 30% of coinfected mice developed recurring 2- to 3-week episodes of acute Candida proliferation, separated by transient recoveries to the carrier state. The frequencies of CD4+ and CD8+ lymphocytes were, respectively, unchanged and significantly decreased (P < 0.05) in both cervical lymph nodes and spleens of coinfected mice compared to the corresponding frequencies in C. albicans-carrying, virus-free, age-matched control animals. Secretion of gamma interferon by concanavalin A (ConA)-stimulated spleen cells from Candida-carrying, retrovirus-infected mice was significantly decreased (P < 0.05) compared to that of C. albicans-carrying, retrovirus-free mice, in accordance with known abnormalities associated with MAIDS. However, production of this cytokine by ConA-stimulated or unstimulated cervical lymph node cells from coinfected mice was enhanced compared to that of virus-free animals colonized with C. albicans. Acquired resistance to reinfection with C. albicans was maintained in retrovirus-infected mice and was associated with a mucosal recruitment of CD8+ cells not observed in control mice. These results suggest that alterations in mucosal immunity which occur in MAIDS differ substantially from defects observed at other sites and that surrogate epithelial defense mechanisms may function locally to limit Candida proliferation.
 ...
PMID:Oral carriage of Candida albicans in murine AIDS. 900 28

Several investigators have shown a comparatively high prevalence of Candida albicans serotype B among HIV-infected individuals. We serotyped oral C. albicans strains from 50 HIV-infected homosexual men, 39 HIV-seronegative homosexual men and 40 clinical oral isolates of a control group. The prevalence of serotype B was significantly higher in homosexual men, regardless of HIV serostatus, than in the control subjects. We suggest that the reported high prevalence of serotype B among AIDS patients in Europe and the USA simply reflects the high proportion of homosexual men among HIV-infected patients. In 22 subjects, oral C. albicans isolates were obtained at two or more time points, up to 8 years apart. No change in serotype was observed over time. The serotype prevalences in HIV-infected patients with oral thrush or AIDS-defining illness were similar to the group of homosexual men as a whole, indicating that there is no serotype-related variation in pathogenicity.
Mycoses
PMID:Increased prevalence of oral Candida albicans serotype B in homosexual men: a comparative and longitudinal study in HIV-infected and HIV-negative patients. 900 57

With AIDS has come a new level of T-cell immunosuppression, beyond that previously seen. The impact of the HIV pandemic on the field of fungal infections includes a major increase in the number of serious fungal infections, an increase in the severity of those infections, and even some entirely new manifestations of fungal illness. In this article fungal pulmonary complications of AIDS are discussed. T-cell opportunists including Cryptococcus neoformans and the endemic mycoses are the most important pathogens. Phagocyte opportunists, including Aspergillus species and agents of mucormycosis, are less important.
 ...
PMID:Fungal pulmonary complications. 901 74

To evaluate the role of fine-needle aspiration biopsy (FNAB) in diagnosis of fungal infections, a retrospective analysis of 26 cases of fungal infection is described. The spectrum of various fungi encountered on cytologic microscopy of aspirated material and fungal culture was as follows: Aspergillus sp (16 cases), Cryptococcus neoformans (six cases), Mucorales (one case), Candida sp (one case), Phialophora parasiticus (one case), Sporothrix schenkii and Cladosporium sp (the last two isolated from a single case). In majority (71%) of cases, fungal infection was not clinically suspected but was picked up on cytologic material in all the cases. An accurate diagnosis based on morphology could be made in 21 cases (80%). Predisposing factor was found in three patients, two of them had diabetes mellitus and one was on immunosuppression. HIV serology was negative in seven cases tested. Commonest tissue reaction (75%) was foreign body giant cells with foamy macrophages and variable amount of necrosis. Although FNAB is helpful in the rapid diagnosis of fungal infections, culture is essential for more accurate identification.
 ...
PMID:Fine-needle aspiration biopsy in fungal infections. 903 33

The incidence and severity of fungal infections appear to increase with progression of HIV disease. Because of the significant morbidity and mortality associated with the mycoses discussed, knowledge of the clinical syndromes, early diagnosis, and prompt institution of therapy are crucial for a favorable outcome. For disseminated or invasive fungal infections, suppressive therapy must be continued to prevent relapse.
 ...
PMID:Fungal infections in patients with acquired immunodeficiency syndrome. 909 34

Progressive disseminated histoplasmosis (PDH), a recognized defining illness of AIDS, is an opportunistic fungal infection caused by Histoplasma capsulatum. The authors report a case of PDH in a HIV-infected African child from a Histoplasma capsulatum non-endemic area. An 8-year-old girl from Kwazulu/Natal, South Africa, was admitted to King Edward VIII hospital with pyrexia and respiratory distress. Pale with generalized lymphadenopathy, she had been sick with general malaise and fever for 3 weeks. A punched-out painless ulcer was present on the child's lower left leg and she had ulcerative lesions on the tip of her tongue and the angle of her mouth. There was a tender hepatomegaly and clinical signs of pneumonia, while a chest roentgenogram showed right upper lobe consolidation with early cavitation. The purified protein derivative tuberculin skin test was negative and no acid-fast bacilli were detected on three sputum samples taken on different days. A Western blot test conducted for antibodies to HIV was positive. Additional laboratory tests were conducted. The patient was treated with parenteral acyclovir for herpesvirus infection, ceftriaxone for severe community-acquired pneumonia, and trimethoprim-sulfamethoxazole because Pneumocystis carinii infection was part of the clinical differential diagnosis. Bone marrow aspirate and trephine biopsy revealed yeast forms of H. capsulatum. The girl died on the second day of hospital admission, before antifungal therapy could be commenced.
 ...
PMID:Disseminated histoplasmosis in a human immunodeficiency virus-infected African child. 910 50


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