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

Mycobacterium gordonae is frequently isolated from urine, but M gordonae genitourinary disease is rare; the majority of the isolates are commensals. We describe a 40 year old housewife who presented with loin pain, dysuria and frequency. Urine contained excessive pus cells, was sterile on culture and she did not respond to broad spectrum antibiotics. There was repeated isolation of M gordonae from the urine and she responded to a standard antituberculosis regimen. She was irregular and non-compliant with supervised therapy and relapsed three months after stopping medications. She again had symptoms and M gordonae was repeatedly isolated from the urine, Mycobacterium tuberculosis and other pathogens were not isolated. There was no evidence of humoral or cellular immunodeficiency or HIV infection.
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PMID:Mycobacterium gordonae genitourinary disease. 154 12

Mycobacterium gordonae is considered the least pathogenic of the Runyon Group II mycobacteria, although there are now well-documented reports of infection varying from localized soft tissue infection to disseminated life threatening diseases. We report a 40-year-old Pakistani housewife, treated in childhood for tuberculosis, who presented with severe systemic illness, fever, ascites, hepatomegaly, persistent dysuria with sterile pyuria, pulmonary disease, and anorexia with weight loss. Liver biopsy histology showed multiple granulomata and multiple isolation of M. gordonae from sputum and urine, in keeping with disseminated mycobacterial infection. She had dramatic response to antituberculosis therapy with streptomycin, isoniazid, rifampicin, and pyrazinamide. No evidence existed for disturbed humoral or cellular immunity and HIV infection. This represents the fifth reported case of disseminated M. gordonae infection, the first from the Arabian Gulf. It was treated successfully with standard antituberculosis regimen.
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PMID:Case report: disseminated Mycobacterium gordonae infection in a nonimmunocompromised host. 177 25

Inpatient and community-based care can be complementary in relation to the management of HIV disease. Medical records from 200 inpatients of Chikankata Hospital near Lusaka, Zambia and 200 home based patients were examined and compared for the common symptoms of presentation of HIV disease, associated opportunistic infections, and treatment protocols. Drug costs of both groups were also compared. The most common respiratory symptoms in the 2 groups are cough, chest pains, weight loss, and hemoptysis. Treatment employed for these symptoms were cortimoxazole, penicillin V, erthromycin, and tetracycline. Acetyl saliclic acid and paracetamol were used for pain relief in both groups. Gastointestinal system symptoms for both groups were diarrhea, weight loss, abdominal pain, and vomiting. Cotrimoxazole and metronidazole were used in treating diarrhea. Additional treatment protocol for the 2 patient samples included oral rehydration therapy for dehydration, antacid or bismuth subsalicylate for diarrhea and enteritis, and mycostatin for oral candidiasis. Central nervous system symptomatology included headache, dementia, neckace, and lethargy. Chloramphenicol was employed in treating bacterial meningitis. Diazepam and chlorpromazine were effective for restless patients. Genito-urinary system symptomatology for the 2 groups included dysuria, genital ulcers, hematuria, viral warts, and buboes. Antibodies were used for sexually transmitted diseases and infections. Skin symptomatology included rash and dermatitis, herpes zoster, abscess, kaposi's sarcoma, ulcers, furunculosis, and discharging anal sinus. In treating these symptoms, hospital based care and home based care were similar. Overall, it was found that hospital treatment protocols were detailed, expensive, and time consuming. Furthermore, hospital treatment for HIV positive patients is more expensive than HIV negative patients; hospital costs for 50 HIV negative patients totaled US$415.94 compared to US$1204.98 HIV positive/PTB negative patients and US$1705.62 for HIV positive/PTB positive patients. Drug cost/patient admission is increased by 469% if HIV positive. (author's modified).
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PMID:Clinical care as part of integrated AIDS management in a Zambian rural community. 248 94

In northern Thailand, baseline interviews with and blood testing for syphilis and HIV-1 antibodies of military conscripts were conducted during May-November 1993. Researchers also examined conscripts discharged in April 1993. They interviewed and tested a total of 2047 men. 134 men (6.5%) had had at least one male sex partner. (These men are referred to as MSM.) Only 4 (2.9%) had had sex with only men. The remaining 130 (97.1%) had also had female sex partners. The 134 MSM men were more likely than heterosexual men to be married (odds ratio [OR] = 2.67) and to have a girlfriend with whom they had sex (OR = 1.6). They were also more likely than heterosexual men to have ever had any sexually transmitted disease (STD) (OR = 2.71), gonorrhea (2.05), syphilis (OR = 3.17), nongonococcal urethritis (OR = 4.54), penile discharge with pus (OR = 2.47), watery penile discharge (OR = 6.24), and dysuria (OR = 2.43). The overall HIV prevalence was 12.1% (247 men). MSM men were only somewhat more likely to be HIV infected (PR = 1.51). MSM men with more than one male lifetime partner were significantly more likely to be infected with HIV than those with only one male partner (OR = 2.89). Same-sex behavior was more common among discharged men who had returned to civilian life than those were still in the military (9.3% vs. 6.5%). Discharged bi/homosexual men was the only group of Royal Thai Army current or former conscripts in which sex with men was independently associated with HIV infection (27.3% vs. 12.4% for HIV-infected heterosexual former conscripts; OR = 2.54). Among all subjects, HIV infection was associated with ever visited a female commercial sex worker (OR = 4.16) and ever had any STD (OR = 5.47), gonorrhea (OR = 3.08), syphilis (OR = 3.81), genital herpes (OR = 3.54), genital warts (OR = 3.56), and genital ulcer disease (OR = 5.59). These findings show that MSM in Northern Thailand are at high risk of STDs and HIV. HIV/STD prevention efforts should target all young Thai men and try to change high risk sexual practices.
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PMID:Same-sex behavior, sexually transmitted diseases and HIV risks among young northern Thai men. 771 88

The authors report a case of cystitis due to Toxoplasma Gondii infection in a patient suffering from AIDS. Initial symptoms consisted of dysuria, extreme frequency and urgent micturition responsible for pseudo urinary incontinence. Urine culture was sterile. Pelvic computed tomography and pelvic MRI demonstrated thickening of the bladder wall and seminal vesicles. Cystoscopy confirmed the presence of an intravesical proliferation with a pseudoneoplastic appearance. The diagnosis of Toxoplasma cystitis was confirmed by the discovery of Toxoplasma cysts on histological examination of bladder biopsies. Toxoplasma cystitis is a rare cause of pseudoneoplastic bullous cystitis in HIV-seropositive patients.
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PMID:[Pseudo-tumoral cystitis due to Toxoplasma in an patient with AIDS]. 771 73

During October 1992 to July 1993 in Abidjan, Ivory Coast, health workers conducted interviews, physical examinations, pelvic ultrasonography, and laboratory testing with 170 women with pelvic inflammatory disease (PID) at the University Hospital of Treichville and four primary care clinics. They compared clinical and microbiological characteristics and the response to PID therapy in 57 HIV seropositive women (cases) and in 113 HIV seronegative women (controls). Cases were more likely than controls to have a temperature of at least 38 degrees Celsius (odds ratio [OR] = 2.5), a genital ulcer (OR = 7.8), and a tuboovarian mass on ultrasonography (OR = 2.6) and to need surgery (OR = 6.5) and hospitalization (OR = 3.5). They also had a higher clinical severity score than did the controls (17.4 vs. 15.4; p = 0.01). Cases with a lower CD4 count (14%) were significantly more likely than cases with a higher CD4 count to have a temperature of at least 38 degrees Celsius (56% vs. 13-19%; p = 0.03) and dysuria (78% vs. 33-41%; p = 0.05). They also tended to have a genital ulcer and a tuboovarian mass, but not significantly so. Among all 170 women, the most common pathogenic organisms responsible for PID were Neisseria gonorrhoeae (29.4%) and Chlamydia trachomatis (9.4%). Neither infection was significantly related to HIV infection. Yet, the cause of PID in cases with the highest CD4 count was less likely to be N. gonorrhea than that of cases with lower CD4 counts (13% vs. 44%; p = 0.07). Among the 162 women who received oral antibiotics, 95% of the 40 cases and 93% of the controls responded to antibiotic therapy within four days. On days 4 and 14, none of these women still had a fever. These findings suggest that HIV infection affected clinical manifestations of PID but did not affect the cause of PID or response to therapy.
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PMID:The impact of human immunodeficiency virus infection on pelvic inflammatory disease: a case-control study in Abidjan, Ivory Coast. 789 86

Although significant bacteriuria and urinary tract infection are more common in immunocompetent women than men, studies linking HIV immunosuppression with an increased risk of developing urinary infection have so far only been carried out in men. We therefore examined the relationship between bacteriuria and HIV status and CD4+cell count in a relatively homogeneous cohort of female commercial sex workers (CSW) attending a community clinic in Nairobi. Two hundred and twenty-two women were enrolled, and grouped according to HIV status and CD4 count. Group 1 were HIV seronegative (n = 52); Group 2 were HIV seropositive with CD4 + counts above 500 x 10(6)/l (n = 51); Group 3 were HIV seropositive with CD4 + counts between 201 and 500 x 10(6)/l (n = 67); Group 4 were HIV seropositive with CD4+counts below 200 x 10(6)/l (n = 52). Clinical signs and symptoms were noted and mid-stream specimens of urine obtained for culture and sensitivity. Overall 23% (50/222) had significant bacteriuria. The rates in each group respectively were 25%, 29%, 19% and 23% and there was no significant association between bacteriuria and HIV status; or between bacteriuria and level of immuno-suppression as indicated by CD4 + count. Overall 19% (30/222) of women had symptoms (frequency; dysuria; loin pain; smelly urine) or signs (fever; loin tenderness) compatible with urinary tract infection. However there was no significant association between symptoms or signs of infection and bacteriuria or HIV status. A typical range of pathogens, predominantly Enterobacteriaceae, were isolated and there were high rates of resistance to commonly used antimicrobials as well as 10% resistance to ciprofloxacin. Although high rates of significant bacteriuria can occur in highly sexually-active women, this appears unrelated to HIV infection or the level of HIV-related immunosuppression and is generally asymptomatic or clinically indistinct.
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PMID:Bacteriuria in a cohort of predominantly HIV-1 seropositive female commercial sex workers in Nairobi, Kenya. 884 92

In an ongoing study we evaluated 71 males and 32 females attending our sexually transmitted diseases (STD) clinic. Intraurethral or endocervical swab specimens were cultured for Neisseria gonorrhea (NG), Ureaplasma urealyticum (UU), Mycoplasma homines (MH), Herpes simplex virus (HSV) and Chlamydia trachomatis (CT), using an ELISA technique and the polymerase chain reaction (PCR). HIV antigen, hepatitis B (HBV) and Treponema pallidum (TP) seropositivity were tested by ELISA. Mean age was 33.4 and range 15-72 years. 83 patients (81%) used condoms only rarely, 35 (35%) had multiple sexual partners and 83 (81%) were treated empirically prior to evaluation. Dysuria and urethral discharge were found in 47 (45.6%), of whom 34 (33%) were males; the majority of females were asymptomatic. A specific etiology for STD was found in 53 patients (51.4%) and 1/3 had more than 1 pathogen. CT, UU, MH, HSV, NG and TV were found in 27, 24, 5, 3, 2 and 1, respectively. 8 patients were seropositive for HBV and 1 for TP; all were seronegative for HIV. CT was the most prevalent pathogen found. All patients with STD symptoms should be screened for all sexually transmitted pathogens, since many of them have more than 1 pathogen. STD clinics in Israel should be developed in conjunction with microbiology laboratories for better management of STD in the community.
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PMID:[Diagnostic and therapeutic approach to sexually transmitted diseases]. 888 2

The determinants of treatment-seeking behaviors associated with sexually transmitted diseases (STDs) were investigated in a cross-sectional survey of 213 men recruited from government clinics (n = 101), private clinics (n = 50), and pharmacies (n = 62) in Bangkok, Thailand. 142 of these men had had a prior STD. 34% of men who initially attended pharmacies and 19% of those who first attended a government clinic sought multiple treatments for prior STDs because of an incomplete response to treatment. 50% of STD clients had visited a commercial sex worker in the 3 months preceding the current STD; half believed a casual or new sex partner was the source of infection. 12% of men had sex while they were symptomatic with the current STD. Advice on condom use was conveyed to 88% of government clinic patients, 94% of private clinic patients, and 52% of pharmacy customers; only 72%, 14%, and 22%, respectively, were urged to contact their sexual partner. Men with less education and symptoms of dysuria were more likely to seek care at drugstores. Also associated with seeking care at a pharmacy rather than a government site were waiting less than 7 days to seek treatment, having a travel time less than 20 minutes, and feeling able to pay for treatment. Those seeking care at pharmacies were also more likely to believe that they would recover at least as well as those treated at a government clinic and to believe they were at risk for human immunodeficiency virus infection. Possible strategies for improving STD treatment at the first point of contact within the health care system include promotion of syndromic STD management among pharmacists and general practitioners, integrated STD programs within health care services already providing care to adolescents and other high-risk groups, and strengthening the referral network to government clinics.
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PMID:Men with sexually transmitted diseases in Bangkok: where do they go for treatment and why? 937 6

This is a study of 189 women attending a family planning clinic in rural South Africa to determine the prevalence of asymptomatic and unrecognized genital tract infections. Genital samples were taken from these women to diagnose infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, Treponema pallidum, and HIV, and to diagnose bacterial vaginosis. Among the 189 women, 41 (22%) reported having had an STD treated in the preceding 12 months. By direct questioning, 74 women stated the following symptoms: genital itch -- 38 (20%); vaginal discharge -- 56 (30%); dysuria -- 33 (18%); dyspareunia -- 22 (12%); and genital ulcers -- 4 (2%). 45 (24%) women had more than one symptom. 119 (63%) women had at least one genital infection, and 49 (26%) had multiple infections. Most of the infections were asymptomatic; while those that were symptomatic, were unrecognized or not reported. Results showed a high prevalence of genital tract infection among the participating women, with most of their infections remaining asymptomatic or unrecognized. Thus, strategies to detect and treat genital tract infections in rural South Africa need to be developed.
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PMID:Family planning services in developing countries: an opportunity to treat asymptomatic and unrecognised genital tract infections? 958 84


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