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

The prevalence of Mycoplasma pneumoniae among HIV-positive patients with community-acquired pneumonia (CAP) remains unclear. We investigated 300 HIV-positive adults (200 with CAP and 100 with no respiratory illness) and 75 HIV-negative adults with CAP for the prevalence of respiratory pathogens using culture and serology. A growth inhibition test was employed to confirm the isolates of M. pneumoniae using species-specific typing sera. The prevalence of M. pneumoniae in HIV-positive subjects was 17% by induced sputum and 11.3% by throat swab culture. The seroprevalence of anti-M. pneumoniae IgM was 11.7% by ELISA and 14.3% by the gelatin microparticle agglutination test. The prevalence of M. pneumoniae among HIV-negative cases was relatively low. Streptococcus pneumoniae was predominant (28%) among subjects with lower respiratory disease, whereas Staphylococcus aureus (15%) was common among upper respiratory symptomatic cases. Rales (P=0.001), pharyngeal erythema (P=0.02), cervical adenopathy (P=0.004), skin rash (P=0.001), and crepitations (P=0.001) were each significantly related to M. pneumoniae positivity. Statistical significance was observed in relation to total lymphocyte count (P=0.02) and erythrocyte sedimentation rate (P=0.04), as well as M. pneumoniae positivity. This study shows that the prevalence of M. pneumoniae in HIV-positive subjects is comparatively higher than in HIV-negative subjects with pulmonary symptoms, and concords with previous pilot studies carried out in Chennai, South India.
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PMID:Epidemiological studies on pulmonary pathogens in HIV-positive and -negative subjects with or without community-acquired pneumonia with special emphasis on Mycoplasma pneumoniae. 1803 30

The objectives of the study are to evaluate the relationship between common HIV-related oral lesions and absolute CD4+ count, age, gender, and medication used and to assess the sensitivity, specificity, positive and negative predictive value of oral manifestations for low absolute CD4+ counts. HIV-positive patients, 200, from south India were selected, whose absolute CD4+ counts were determined within 2 weeks of oral examination. Sociodemographic data was obtained using a structured questionnaire. Oral manifestations were diagnosed according to presumptive criteria of EEC-clearinghouse classification (1993). Four or more concurrent oral lesions were statistically significant with low CD4+ counts <200 cells/mm3 (P = 0.005). The highest and lowest mean CD4+ cell counts were seen in individuals with linear gingival erythema (LGE; 172.5 cells/mm(3)) and pseudomembranous candidiasis (PC; 87 cells/mm(3)), respectively. Smoking, age (<35 years), and males had a positive association with oral hairy leukoplakia (OHL; P < 0.05). Patients with CD4+ counts < 200 cells/mm(3) were associated with 15 times greater risk of PC and four times at greater risk for occurrence of any oral manifestation. Concurrent oral manifestations (>or=4) were good predictors (80-100%) of severe immune suppression. In most resource poor countries where facilities for undertaking CD4+ counts are not available, the presence of concurrent oral manifestations may be used as an indicator of deteriorating immune status.
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PMID:Oral manifestations as predictors of immune suppression in a HIV-/AIDS-infected population in south India. 1966 6

A 64-year-old woman presented with a one-and-one-half year history of an enlarging, red-brown, firm plaque on the left thigh, with numerous, scattered, indurated, hyperpigmented patches on the lower extremities. Histopathologic examination of the largest plaque confirmed the diagnosis of erythema elevatum diutinum, which is a rare form of leukocytoclastic vasculitis that is associated with many disease entities, which include human immunodeficiency virus infection, malignant conditions, hematologic abnormalities, chronic infection, and autoimmune and connective-tissue disorders. The treatment of choice is dapsone; however, several other treatment modalities have been reported to be of benefit.
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PMID:Erythema elevatum diutinum. 1906 12

Antibiotic prophylaxis has been employed to reduce the risk of infection. Many reports have documented the role of prophylactic antibiotics on the subsequent development of infection in patients undergoing surgical as well as a variety of percutaneous interventions including cardiac, vascular, biliary, genitourinary, and drainage of fluid collections. While prophylactic antibiotics can be critically important for certain procedures, their use can be associated with allergic reactions (including anaphylaxis), development of bacterial resistance, and increased costs of medical care. In this analysis, we report the incidence of clinical infection following minimally invasive interventions for dialysis access procedures. Hemodialysis (HD) and peritoneal dialysis (PD) patients undergoing consecutive percutaneous interventions (n = 3162) for HD and PD access were included in this study. Procedure-related clinical infection was defined as the presence of fever/chills, tenderness, erythema, swelling within 72 hours postprocedure. The procedures included percutaneous balloon angioplasty (arterial and venous) [n = 2078 (AVF = 1310; AVG = 768)], venography for vascular mapping (n = 110), endovascular stent insertion (n = 26), intravascular coil placement (n = 31), thrombectomy for an arteriovenous fistula (n = 106), thrombectomy for an arteriovenous graft (n = 110), tunneled hemodialysis catheter (TDC) insertion and exchange (n = 283), TDC removal (n = 160), and insertion of accidentally extruded TDC through the same exit site (n = 9). There were 260 peritoneal dialysis catheter insertions and 15 repositioning procedures. Only patients undergoing TDC insertion for accidentally extruded catheter and PD catheter placement received antibiotic prophylaxis within 1-2 hours before the procedure. Extruded TDC received 1 g of cefazolin while PD catheter insertion had 1 g of intravenous vancomycin. Povidone iodine was used for skin antisepsis in all cases. One patient (0.04%) postangioplasty and one patient (0.3%) after tunneled catheter placement developed clinical infection manifested by fever, chills, and malaise within 24 hours of the procedure. Both required hospitalization. Patient with angioplasty was a diabetic with an arteriovenous graft while TDC insertion was performed in a patient with advanced HIV. Percutaneous dialysis access procedure infections are generally low and might not warrant routine administration of antibiotic prophylaxis for all cases except for PD catheters and accidentally extruded TDC.
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PMID:Antibiotic prophylaxis: is it needed for dialysis access procedures? 2033 23

Erythoderma first described by Hebra in 1868 is a reaction pattern, characterised by generalised and confluent erythema with desquamation affecting more than 90% of body surface and is usually accompanied by systemic manifestation including some metabolic changes. Tile study was envisaged to assess their profile of aetiology, clinical features and to correlate with histopathological findings. Twenty-four patients (18 males and 6 females) with erythroderma were considered for the study. All patients were hospitalised, detailed history was taken and were subjected to relevant investigations--haemogram, serum proteins, liver and renal function tests, routine and microscopic urine tests, HIV screening, x-ray chest, ultrasound abdomen, FNAC of enlarged lymph nodes and skin biopsy. The age group affected ranged between 7 and 70 years, peak incidence between 50 and 60 years. The male to female ratio was 3:1. Scaling, erythema and pruritus were predominant clinical manifestations. In 12 clinically suspected psoriatic erythroderma, only in 6 cases the histopathological features were correlated to psoriasis and remaining showed non-specific chronic dermatitis. Two patients were found to be HIV-positive. There is good clinicopathological correlation in erythroderma caused by lichen planus, atopic dermatitis, seborroeic dermatitis, non-bullous congenital ichthyosiform erythroderma. Drugs were found to be aetiological factor in 3 cases. The study was conducted to assess variations in clinical, aetiological and histopathological profile of erythroderma. The present series had high percentage of erythroderma secondary to preexisting dermatoses. The onset of disease was insidious except in drug-induced erythroderma where it was acute.
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PMID:Aetiopathological and clinical study of erythroderma. 1958 19

Imiquimod 5% cream (Aldara, Graceway Pharmaceuticals) is an immune response modifier used for the topical treatment of anogenital warts in non-HIV-infected patients. Several randomized controlled trials have demonstrated that imiquimod 5% cream is a safe and efficacious treatment. Current data regarding efficacy shows that complete clearance of warts occurred in up to 50% of patients treated with imiquimod 5% cream applied once-daily, 3 times per week for up to 16 weeks. Recurrence rates ranged from up to 19% at 3 months to 23% at 6 months. Imiquimod 5% cream showed an acceptable safety profile; local inflammatory reactions were the most frequent adverse effects, with local erythema being the most common.
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PMID:Safety, efficacy & recurrence rates of imiquimod cream 5% for treatment of anogenital warts. 1960 71

We report the case of a 74-year-old male patient with a one-year history of chest pain in the suprasternal notch associated with erythema, edema and drainage of purulent material from a fistulous lesion. The patient was HIV-negative with no history of TB. A CT scan of the chest showed an osteolytic lesion in the sternum, and a biopsy revealed caseous granuloma, which, in the microbiological evaluation, was negative for fungi and acid-fast bacilli. The diagnosis of sternal osteomyelitis caused by Mycobacterium tuberculosis was confirmed using PCR.
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PMID:Sternal osteomyelitis caused by infection with Mycobacterium tuberculosis. 1966 10

Duodenal infection by Mycobacterium avium-intracellulare is a common opportunistic disease in HIV-infected patients. Individuals with CD4 counts <50 cells/mm3 are at highest risk. The main symptoms are diarrhea, abdominal pain, weight loss, and fever. Endoscopic examination shows various abnormalities including disseminated nodules that may be yellowish, whitish, or pinkish in color. Other mucosal lesions may be found such as erosion, erythema, or friable edematous aspect. Since these findings are non-specific, it is important to obtain biopsy specimens for histological and microbiological examination. The most common histologic features are atrophic mucosa resembling Whipple's disease with strongly positive PAS staining. The presence of BARR in macrophages is typical of MAI. Diagnosis is based on identification of the bacteria using either conventional culture techniques or polymerase chain reaction (PCR). Differential diagnosis includes other gastrointestinal infections associated with AIDS, i.e., microsporidiosis, cryptosporidiosis, giardiosis, anguillulosis, CMV, and isoporosis. The course of the disease is usually unfavorable even with antibiotic treatment. The purpose of this report is to describe a case of duodenitis due to atypical mycobacterial infection in a 30-year-old woman who was seropositive for human immunodeficiency virus. She was hospitalized due to fever with deterioration of her general condition (more than 10% of body weight loss) and chronic abdominal pain with inflammation. Diagnosis of MAI was confirmed by biopsy and Ziehl-Neelsen coloration. The patient was treated with rifampicine, isoniazide, ethambutol, and pyrazinamide in association with stavudine, lamuvidine and efavirenz. Despite improvement of general condition, fever persisted and the patient died after 40 days of treatment.
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PMID:[Chronic abdominal pain and fever in an Ivoirian woman: Mycobacterium avium-intracellulare duodenitis in an AIDS patient in Abidjan, Cote d'Ivoire]. 2009 79

A large number of studies showed that hairy leukoplakia, pseudomembranous candidiasis, Kaposi' sarcoma, non-Hodgkin's lymphoma, linear gingival erythema, necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis were the most common lesions in patients with HIV infection and AIDS, and their higher prevalence and incidence rates correlated with the falling CD4 counts and higher virus load of the patients. The use of highly active antiretroviral therapy (HAART) was associated with decreases in the prevalence of oral diseases. Oral manifestations may represent early signs of AIDS disease and call attention to disease progression. Oral fluid has been shown to possess superior sensitivity for HIV antibody detection as serum.
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PMID:[Progress on study on oral lesions in patients with AIDS]. 2014 59

A 32 year old Indian male patient presented with chief complaints of a high fever, erythema on ear, severe polyarthritic joint pains & swelling, non pitting pedal oedema, facial puffiness and itching for past four days. He had no significant past medical and drug history and was serologically confirmed to have Chikungunya. Oral cavity inspection revealed whitish non erythematous pseudo membranous plaques on the hard palate, buccal surface of cheek and the floor of the mouth which was later microbiologically confirmed as Candidiasis. He tested negative for HIV and had leucopenia with severe CD4 T-lymphocytopenia. This is the first report of an opportunistic infection with CD4 T-lymphocytopaenia in Chikungunya fever.
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PMID:Oral candidiasis in Chikungunya viral fever: a case report. 2020 86


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