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

Mycobacterial infections are consisted of three categories; tuberculosis, nontuberculous mycobacterioses, and leprosy. Tuberculosis is a systemic infectious disease involving respiratory, genitourinary and lymphatic systems caused by Mycobacterium tuberculosis complex (Mycobacterium tuberculosis, M. bovis, M. africanum, and M. microti). Extrapulmonary tuberculosis remains a significant clinical problem because symptoms and signs may be difficult to recognize and to relate to tuberculosis. Miliary tuberculosis is responsible for up to 10% of predominantly extrapulmonary cases. HIV-related miliary tuberculosis is rapidly progressive and almost always fatal without treatment. Nontuberculous mycobacteria (NTM) have been commonly implicated as opportunistic pathogens in patients with underlying disease or immunosuppression including AIDS. M. avium complex (M. avium and M. intracellulare) and M. kansashii are most common causes of nontuberculous mycobacterial diseases in humans. M. leprae is the causative agent of leprosy, an infection of the skin, mucous membranes, and peripheral nerves. This disease is rare in Japan, yet it remains a major problem in some part of the world.
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PMID:[Classification and concept of mycobacterial infections]. 988 5

Tuberculoma of the spleen has been an extremely rare entity during the last decades in the Western world. We describe a case in a young, HIV-negative woman who was evaluated for fever of unknown origin. The workup was initially negative, and she was treated successfully with steroids and nonsteroidal anti-inflammatory analgesics. Recurrence of the fever and an abnormal CT of the abdomen lead to an exploratory laparotomy, which revealed a subcapsular caseous material containing splenic abscess. The very few cases reported in the literature, and the increasing incidence of extrapulmonary tuberculosis due to the alarming numbers of immunodeficient patients that a surgeon may encounter are also discussed.
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PMID:Tuberculoma of the spleen: a rare but important clinical entity. 992 45

The aim of this study was to evaluate the clinical and epidemiological particularity of pediatrics nosocomial HIV infection. Our study group consists of 167 HIV serum-positive nonmaternally infected children who died of AIDS in 1990-1997 (inclusive) in Colentina Hospital of Infections Diseases--Bucharest. Fifty per cent of institutionalized children and 28% of family children died in the first two years of life. About 80% of children were revealed too late as HIV infected. It has been observed a relatively high prevalence values for: multiple or recurrent pneumonia--74.8%, recurrent or chronic diarrhea--87.4%, encephalopathy--65.8%, weight-growth deficiency--100%, disseminated or extrapulmonary tuberculosis--13.8%, HBsAg carriage--59.8%; and low prevalence values for: lymphoid interstitial pneumonia--16.5%, Pneumocystis carinii pneumonia--11.4%, cytomegalovirus diseases--1.8%, cryptosporidiosis--1.8%. The evolution of HIV infection (weight-growth deficiency and encephalopathy) were aggravated in hospitalised children (especially, in the first two years of life). Nutrition and hygiene care factors positively influence the evolution of HIV infection. Multiple or recurrent pneumonia are out of an important prognostic value in the appreciation of SIDA evolution. The incidence and severity of tuberculosis increased at older children. The too late diagnostic of HIV infection had unfavourable influence upon the life expectancy of children.
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PMID:[The clinico-epidemiological aspects of HIV infection in 167 children nonmaternally infected who have died with a diagnosis of AIDS]. 993 2

Intestinal perforation is an extremely uncommon complication of Mycobacterium tuberculosis (MTB) infection. We report a case of HIV infection in a male injecting drug user (IDU) with intestinal tuberculosis complicated with multiple ileal perforations at the Regional Institute of Medical Sciences Hospital, Imphal, Manipur. The emergency surgical therapy supported by antitubercular drugs (ATT) and parenteral nutrition saved the life of this patient who presented in a critical state of shock. The patient manifested with extrapulmonary tuberculosis, which is one of the criteria of AIDS. The authors stress the possibility that in future, tubercular complication till now considered atypical, may become more frequent.
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PMID:Multiple tubercular ulcer perforation of ileum in an AIDS patient: case report. 1009 25

Despite the rising morbidity and mortality of tuberculosis in patients with HIV infection, epidemiology of tuberculosis in the Ivory Coast remains under-documented. The aim of this retrospective study of 1638 cases of tuberculosis diagnosed in the Pneumology Department of the Abidjan University Hospital was to collect current epidemiological data. From 1986 to 1992, a total of 4631 patients were hospitalized at University Hospital-Abidjan. Clinical and serological tests to detect HIV infection were performed in 982 patients. During hospitalization all patients received the same treatment for tuberculosis (2RHZ/4RH). Tuberculosis accounted for 42 p. 100 of diagnoses with a prevalence of 234 patients per year and a rate of increase was 4.5 p. 100 per year. Most patients were between the ages of 20 and 40 years (59 p. 100) and of male sex (72 p. 100). Overall HIV seroprevalence was 44.5 p. 100 with a rate of increase of 4.4 p. 100 per year. The proportion of patients tested for HIV grew from 11 p. 100 to 98 p. 100 over the seven-year study period and infection rates were consistently higher in men than in women (sex ratio: 3 to 1). The mean percentage of extrapulmonary or disseminated tuberculosis was sharply higher in the last three years of study (from 23.5 p. 100 to 46 p. 100 after 1989). This study demonstrates that seroprevalence rate has increased and that this increase has been correlated with a rising incidence of lethal and extrapulmonary tuberculosis.
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PMID:[Epidemiology of tuberculosis in Abidjan, Ivory Coast: effects of HIV infection]. 1054 91

The number of people infected with human immunodeficiency virus (HIV) is gradually increasing in Japan, and the morbidity rate from tuberculosis in the Japanese people is high. Accordingly, the number of cases with both infections is considered to increase in the future. Our hospital has already encountered 22 cases of HIV associated tuberculosis. HIV infects mainly CD4-positive cells. The extreme decrease in the cell count results in serious cellular immunological disorder. CD4-positive cell disorder induces disorders of B lymphocytes, cytotoxic T cells, natural killer cells, and macrophage functions. These destructive conditions show the state of immunodeficiency including macrophage that are most important for defense of acid-fast bacterial infection. Migration and activation of macrophages with cytokines derived from T cells are impaired to induce the following phenomena: hypoplasia of granuloma, failure of tubercle bacillus sppression, the spread to regional lymph nodes (hilar or mediastinal lymph nodes), and hematogenous dissemination. On this occasion, caseous necrosis and cavitation are unlikely to occur, and false-negative tuberculin reaction is often observed. The incidence of severe cases, which include miliary tuberculosis, tuberculous meningitis, etc., and extrapulmonary tuberculosis, are high among acquired immunodeficiency syndrome (AIDS)-associated tuberculosis cases. HIV-infected tuberculosis cases are generally regarded as endogenous exacerbation, but they include primary infection and reinfection as well. Even during the treatment for drug-sensitive strains particularly, some cases may have reinfection with multidrug-resistant bacteria, suggesting that caution should be taken against this point. Conversely, the association of tuberculosis is a factor for the poor prognosis of HIV infection, since it facilitates the development of HIV infection. If the bacteria belong to a drug-sensitive strain, the infection with them responds well to antituberculous drugs, the same as in tuberculosis cases without HIV infection, showing a favorable prognosis. However, the mortality rate of infection with multidrug-resistant tuberculosis is extremely high.
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PMID:[Factors for the onset of and the exacerbation of tuberculosis. 5. The infection and prognosis of tuberculosis among patients with immunodeficiency, especially HIV-infected patients]. 1056 37

Disseminated extrapulmonary tuberculosis is uncommon in no immunocompromised hosts. We described the case of a 68-year-old HIV seronegative man, who presented with a 5 months history of constitutional symptoms, generalized lymphadenopathy, evening fever, osteomyelitis of the left fibula and cutaneous lesions (papules and pustules). There was neither clinical nor radiological evidence of pulmonary involvement. On the basis of bacteriological and pathological findings the diagnosis of disseminated extrapulmonary tuberculous was made.
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PMID:[Disseminated extrapulmonary tuberculosis with skin, lymph node and bone involvement]. 1060 72

From January 1990 to July 1998, twelve patients (10%) among 120 patients with human immunodeficiency virus infection who were hospitalized in the Veterans General Hospital-Taipei, were proved to have Mycobacterium tuberculosis infection. The mean age of these patients was 38 years, range: 25-62 years. All patients studied were in the advanced stage of acquired immunodeficiency syndrome (AIDS) with a mean circulatory CD4 lymphocyte count of 21/microL (range: 0-64/microL) and a much higher HIV viral load at initial diagnosis of M. tuberculosis infection. Because of no significant difference in the HIV viral load between patients with active pulmonary tuberculosis and those with extrapulmonary tuberculosis in this study, dissemination of M. tuberculosis did not correlate directly with a high HIV viral load, but was possibly related to the virulence of the organism itself. Chest radiographic findings at initial diagnosis of pulmonary tuberculosis were variable and atypical. Most patients (62.5%) presented with a primary pattern (lower lobe or diffuse infiltrates), while hilar lymphadenopathy was noted in more than half of the patients and cavitation was less common (only one patient). Ten patients (83.3%) had extrapulmonary involvement; the most common site being the lymph nodes. Most patients with classic drug-sensitive tuberculosis responded well to conventional standard regimens of anti-tuberculosis therapy. Since tuberculosis is transmittable, treatable, and possibly preventable, moreover the clinical presentation of tuberculosis in the patients with AIDS may be atypical and unusual, clinical physicians must keep an alert dealing with these patients for early identification and early treatment.
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PMID:Clinical analysis of Mycobacterium tuberculosis infection in patients with acquired immunodeficiency syndrome. 1065 Apr 89

Extra-pulmonary tuberculosis remains a diagnostic and therapeutic challenge; its clinical presentation can mimic a wide range of pathological conditions. Here we report on 3 female patients who presented with supra-sternal masses that were suspected clinically to be of thyroid origin. By use of fine-needle aspiration cytology (FNAC), they were proved to be tuberculous lesions involving the pre-tracheal lymph nodes. Serological examination for HIV-I/II was not reactive in the 3 patients. The patients responded well to a regimen of multi-drug therapy. It is concluded that extra-pulmonary tuberculosis should be considered in the differential diagnosis of thyroid or para-thyroid swellings and that FNAC is a simple, quick and reliable procedure in the diagnosis of extra-pulmonary tuberculous lesions involving the neck.
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PMID:Supra-sternal notch tuberculous abscess: a report of three cases. 1074 2

From September 1996 to June 1997, in an area bordering East London, we prospectively collected epidemiological, clinical and microbiological data on all patients with newly diagnosed culture-positive tuberculosis and compared these to national data based on notifications. The significant differences were that tuberculosis was diagnosed almost exclusively in non-Caucasian patients (42/47 [89%]) and that there was a high percentage of extrapulmonary tuberculosis (27/47 [57%]) including four cases of tuberculous meningitis and five cases of osteomyelitis. We also observed that 19/27 (70%) of patients with extrapulmonary tuberculosis had normal chest X-rays, 3/17 (18%) sub-Saharan Africans were HIV antibody-positive and drug resistance strains were isolated from six sub-Saharan Africans and one Caucasian. Figures for treatment failures and mortality compared favorably to national averages at 6 months. National data do not accurately reflect local epidemiology and clinical presentations. Hospital-based surveillance and promoting awareness of local differences is essential to prevent delayed diagnosis, inappropriate management and poor clinical outcome.
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PMID:Tuberculosis in an area bordering east London: significant local variations when compared to national data. 1078 96


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