Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The major agents responsible for atypical pneumonia in children include a wide variety of organisms, one Mycoplasma species, two Chlamydia species, a rickettsia, and one fastidious bacterium. Mycoplasma pneumoniae and C. pneumoniae together may be responsible for over 40% of these infections. Recognition of the role that these agents play in pneumonia is important since many of the diagnostic methods used to detect these organisms are not available in most hospital microbiology laboratories. If you don't look, you won't find. Epidemiologic factors can provide valuable clues, especially with the less frequently encountered infections, since it is almost impossible to make a clinical diagnosis on which to base treatment. A reliable history of avian exposure should suggest psittacosis, exposure to sheep or pregnant cats suggests Q fever, and children with underlying malignancy or immunodeficiency or those receiving systemic steroids may have legionnaires' disease. None of these organisms are susceptible to beta-lactam antibiotics. Sometimes the diagnosis is not considered until after the child has failed to respond to a penicillin or a cephalosporin and routine bacteriology is negative. In view of the role played by M. pneumoniae and C. pneumoniae, a macrolide may be the first-line antibiotic for atypical pneumonia in children.
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PMID:Atypical pneumonias in children. 771 3

The objective was to evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic at the John Hunter Clinic, London. A retrospective case note review of women attending the FPC during the first year January-December 1992 was performed. Data were extracted on: prior STDs, parity and pregnancies terminated; screening for STDs, serology and cervical cytology; contraception on first attendance, that supplied, and outcome over the subsequent year 1993. 113 women, 13-41 years old, attended the FPC. 45 were new attenders, 6 had previously tested antibody positive for the human immunodeficiency virus (HIV), 7 were intravenous drug users; 61 (54%) had a history of sexually transmitted disease (STD); 20 (17.7%) were using no contraception; 37 (32.7%) had previous termination of pregnancy (TOP) with 70 TOPs in total. Within 3 months of FPC attendance, 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13, and 62 women, respectively. Infections identified were similar to those identified in the GUM clinic, although the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV-positive results were identified; 5 women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance 6 women required post coital contraception (PCC) and 5 were already pregnant: 3 suspected it, and 2 were unaware. During the year 3 women conceived; 2 used COCP, but were noncompliant; 1 used a diaphragm with unclear compliance. 7 of the 8 pregnancies were terminated. Over the following year, 1992-93, contraception was supplied to 42 women (37.2%); 4 required PCC; and 2 intentional pregnancies occurred. Only 1 of the TOP women returned. Continuation of the project is deemed essential.
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PMID:Evaluating a designated family planning clinic within a genitourinary medicine clinic. 749 63

A seroprevalence survey conducted in rural Uganda revealed a high potential for interaction between sexually transmitted diseases (STDs) such as herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV). Venous blood samples were collected at baseline and one year later from 294 randomly selected adults aged 15 years or over from two neighboring villages. At baseline, 23 (7.8%) adults were HIV-positive; no seroconversion occurred during the one-year study period. STD prevalence rates were 10.8% for syphilis, 10.4% for Hemophilus ducreyi, 66.0% for Chlamydia trachomatis, and 91.2% for HSV-1 and 67.9% for HSV-2. More females (74.4%) than males (57.0%) were HSV-2 antibody-positive. Reactivity to H. ducreyi, C. trachomatis, and HSV-2 rose with increasing age, but there was no such trend for syphilis. HIV prevalence rates were 0.0% among those with no serologic evidence of previous STDs, 2.6% among those with one or two prior STDs, and 20.0% among those with three or four STD markers. Of particular concern was the high rate of HSV-2 prevalence among adolescents (85% among females aged 20-24 years and 82% in males aged 25-29 years). It is suggested that age-specific HSV-2 seroprevalence can provide an accurate marker of premarital sexual activity among Ugandan adolescents since it lacks the potential for bias associated with self-reporting in this population.
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PMID:Seroprevalence and incidence of sexually transmitted diseases in a rural Ugandan population. 781 50

This recently recognised member of the genus Chlamydia is one of the most widespread pathogens of man, though up to 90% of infected people have few or no symptoms. Several studies have estimated the population prevalence of antibodies to C. pneumoniae at 40-55% in the northern hemisphere, and over 60% in under-developed countries. The incidence of infections follows a cyclical pattern, with peaks at regular intervals of 2-10 years, but no apparent seasonal periodicity. Nosocomial transmission may be mediated by environmental surfaces as well as aerosols, and immunosuppression, for example by the human immunodeficiency virus, predisposes to infection. Chlamydia pneumoniae causes predominantly atypical pneumonia, often severe in adults, especially the elderly; including 5-10% of community-acquired pneumonia in Scandinavian countries. Serological evidence indicates associations with asthma, bronchitis, exacerbations of chronic airflow obstruction, otitis media and bronchiolitis. Several studies, using both serological and morbid anatomical techniques, also indicate associations with vascular atheroma and ischaemic heart disease, and with acute myocardial infarction. Chronic, latent and recurrent infections have been documented, and it is postulated that, like chronic or recurrent C. trachomatis infections, these may produce disease as a consequence of the host's immunological hypersensitivity. Several techniques are available for serological diagnosis: the technique of choice is micro-immunofluorescence, using fixed whole elementary or reticulate bodies as antigen, but antibody responses are highly variable. Traditional alternatives, antigen detection (by direct immunofluorescence or enzyme immunoassay) and cell culture, have major disadvantages. Polymerase chain reactions have not yet been widely applied to the clinical setting. tetracycline antibiotics, erythromycin and quinolones are not very efficacious in the treatment of C. pneumoniae infection. The azalide antibiotic, azithromycin, and the macrolide, clarithromycin, are active in vitro against C. pneumoniae, and may become treatments of choice. The development of anti-chlamydial vaccines remains an important research goal.
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PMID:Clinical aspects of Chlamydia pneumoniae infection. 789 84

To study the interactions between Chlamydia trachomatis (CT) and human immunodeficiency virus (HIV) infections, we examined CT serologies in sequential serum samples of male homosexuals (MHS), followed over a mean period of 4 years. Of the MHS studied, 77 were HIV(-), 18 were HIV(+) and 10 patients seroconverted during the study period. Seventy matched heterosexual controls were tested concomitantly. CT-specific antibodies of both IgG and IgA isotypes were determined by an immunoperoxidase assay, indicating past and active infection respectively. Anti-CT IgG was frequently observed in both HIV(-) and HIV(+) MHS (40-50% vs. 23% of controls) and IgA antibodies were also common in both MHS groups (15-20% vs. 1.5% of controls). After HIV infection, no increase in CT antibodies occurred. We found serological data suggestive of active CT infection preceding seroconversion in 3 of 10 seroconverters vs. 5% of matched MHS controls who remained HIV(-) (P < 0.025), indicating a possible effect of CT infection on the acquisition of HIV should be further studied.
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PMID:Chlamydia trachomatis and HIV infection. 792 10

We conducted a prospective study of 385 patients who had community-acquired pneumonia with use of a modified polymerase chain reaction (PCR) assay that detects amplified DNA by enzyme immunoassay (EIA). We used PCR-EIA to improve detection of Chlamydia pneumoniae infection and to differentiate C. pneumoniae infection from other chlamydial infections. Cultures of throat swab specimens from four patients yielded Chlamydia species (C. pneumoniae, one patient; Chlamydia species, two patients; and C. psittaci, one patient). C. pneumoniae was repeatedly detected by PCR-EIA for thirteen (3.4%) of these 385 patients. Six of these 13 patients were infected with the human immunodeficiency virus. Ten (76.9%) of the patients who were positive by PCR-EIA had IgG titers of > or = 1:16, and two (15.4%) of the 13 patients had IgG titers of < 1:16; no sera was available in one case. Other pathogens were recovered in eight (61.5%) of the 13 cases in which C. pneumoniae was detected by PCR-EIA. In addition, for 46 (11.9%) of the 385 patients the titers of antibody were considered diagnostic of C. pneumoniae infection; however, as 36 of the 46 patients were infected with the human immunodeficiency virus (which may have affected their serological response to C. pneumoniae), interpretation of these titers was problematic. As PCR-EIA was more sensitive than was culture for detecting C. pneumoniae infection in this study, this method may be a valuable tool for the prompt diagnosis of this infection.
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PMID:Diagnosis of Chlamydia pneumoniae infection in patients with community-acquired pneumonia by polymerase chain reaction enzyme immunoassay. 794 21

The prevalence of untreated sexually transmitted diseases (STDs) was assessed in a cohort of 372 sexually active inner-city women (92% black, 49% US-born) with no history of injection drug use who were recruited in Brooklyn, New York, in 1990 and 1991. The presence of STDs was assessed via culture, serologic analyses, and medical history. Sexual and drug-use histories were obtained, as was a urine sample for toxicologic analysis. Thirty-five percent of the women had at least one STD (27% Trichomonas vaginalis, 6.8% Chlamydia trachomatis, 5.2% syphilis, 2.4% human immunodeficiency virus (HIV), and 1.4% Neisseria gonorrhoeae). US-born women were more likely than foreign-born (96% Caribbean) women to have an STD (50% vs. 22%; p < 0.001). Among US-born women, 61% of crack and/or cocaine users had an STD as opposed to 34% of non-users (OR = 2.9, 95% CI 1.6-5.5). Recent crack cocaine use was the strongest predictor of syphilis infection (OR = 12.8, p = 0.019), and was reported by each of the seven HIV-positive women. This study, based on a large sample with laboratory confirmation of both STDs and drug use, documents that women who use crack cocaine are at substantially higher risk of contracting an STD than other women. STD/HIV prevention programs in inner cities should target US-born women, particularly crack cocaine users.
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PMID:Sexually transmitted diseases, sexual behavior, and cocaine use in inner-city women. 871 2

Two groups of six cats were established, one a control group and one infected with feline immunodeficiency virus (FIV) 18 months previously. The cats in both groups were inoculated with Chlamydia psittaci and the clinical progression of the infection was monitored by means of a clinical scoring system for 10 months. Haematological, serological and viral and chlamydial isolation studies were also made. The response of the FIV infected group to treatment with oxytetracycline was monitored in the 11th and 12th months. The FIV infection prolonged the duration of the clinical signs resulting from the infection with C psittaci and led to the development of chronic conjunctivitis. The haematological and antibody responses to C psittaci were comparable in the two groups. However, it was possible to isolate C psittaci from the FIV-infected cats up to day 270, when the treatment began, but only up to day 70 in the control group. In addition, it appeared that the infection with a secondary pathogen may have accelerated the clinical progression of the FIV infection.
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PMID:Clinical aspects of Chlamydia psittaci infection in cats infected with feline immunodeficiency virus. 800 98

The onset of Acquired Immunodeficiency Syndrome (AIDS) is often characterized by a variety of symptoms, with the involvement of several tissues and organs. In the present case a polyarthritic syndrome was the symptomatology at the onset. Clinical onset. A 26 year old man, drug abuser, anti HIV positive, with a CD4/CD8 ratio = 0.8, was observed in January 1990. He presented polyarthritic involvement of the ankles and right knee, conjunctivitis and successfully keratodermia. The diagnosis of Reiter syndrome was made on the basis of the clinical features and laboratory findings (Chlamydia in his urethral secretion). The patient did not denote any symptom of immunodeficiency, except small lymphonodal painless swelling in axillary and latero-cervical region. A significant clinical improvement was obtained with chlortetracycline at a dosage of 100 mg daily and 6 methylprednisolone 12 mg daily. Comment. This experience suggests the importance and the usefulness of the anti HIV test in patients affected by a reactive arthritis, as the Reiter's syndrome, since the progressive diffusion of the HIV infection.
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PMID:[A case of Reiter syndrome in HIV infection]. 801 92

Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily all over the world. Recent reports have suggested an association between HIV and sexually transmitted disease (STD). We conducted a case study among foreign female prostitutes who were seropositive to HIV to determine the prevalence of STD. In this study, we checked the prevalence of STD infection in 19 HIV seropositive female prostitutes. Overall, 84 percent were seropositive for Chlamydia trachomatis, 37% for HBs, 32% for Treponema pallidum (Tp) and 6% for hepatitis C virus (HCV). The high frequency of a history of STD may be associated with an increased risk of HIV infection acquired through heterosexual contact. Prevention of heterosexually transmitted HIV infection will require an extensive educational program aimed specifically at the risk associated with the number and selection of sexual partners and at promoting safer sexual practices.
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PMID:[Sexually transmitted disease infection in HIV carriers]. 802 94


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