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)

We present the findings in a patient having sickle cell disease who developed multilobar pneumonia. Cultures of bronchial aspirates and histologic specimens grew Cryptococcus neoformans. There was neither spontaneous clearing of the infection nor a response to bactericidal antibiotics. The patient had no underlying malignant neoplasm or immunodeficiency as indicated by history, physical examination, and specialized tests of humoral and cell-mediated immunity.
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PMID:Cryptococcal pneumonia in a patient with sickle cell disease. 370 57

Despite differences in the modes of transmission of human immunodeficiency virus (HIV) in Africa as compared to US and Europe, the immunologic abnormalities and clinical profile in acquired immunodeficiency syndrome (AIDS) appear to be similar. Further evidence for this observation is provided by the case of a 34-year-old African male from Burundi who developed a form of oral leukoplakia previously unseen in African AIDS patients, but resembling the so-called hairy leukoplakia found in homosexuals in California. In this African patient, the diagnosis of AIDS was established on the basis of severe opportunistic infection (meningeal cryptococcosis) together with hepatic and pulmonary tuberculosis, a severely decreased T-helper to suppressor cell ratio, and the presence of antibodies to HIV. Dermatological examination revealed several mucocutaneous lesions, including 1) candidiasis with patchy depapillation of the dorsum of the tongue and 2) discrete, chronic lesions on the lateral sides of the tongue appearing as dense, white mucosal patches about 1 cm in size. A sample of a persistent white lesion on the lateral border of this patient's tongue was submitted to light and electron microscopic examination and immunoassay. The epithelium of the lingual mucosa presented parakeratotic cells, acanthosis, and surface projections typical of "hairy" leukoplakia. The prickle cells contained pyknotic nuclei and perinuclear halos. Herpes-like virus particles were observed within the nuclei of this prickle cells and in intercellular spaces. There was no evidence of papillomavirus particles. In immunoassay, the virus particles did not react to antibodies against human herpes virus. The role of herpes virus and papillomavirus in the pathogenesis of "hairy" leukoplakia has yet to be established.
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PMID:Oral "hairy" leucoplakia in an African AIDS patient. 373 24

In a survey of 301 normocomplementemic inbred mice (belonging to nine different strains: BALB/cN nu/nu and nu/+, CBA/N, C57BL/KsJ, C57BR/cdJ, CBA/CaJ, BRVR, DW/+, and C57BL/6J) for natural resistance to Cryptococcus neoformans, cumulative survival values were found to range from 12 to 22 days. When the average organ weights of infected animals were compared with reference values obtained in uninfected mice of the same age and genetic lineage, the following changes were documented. In the CBA/N strain, the mean spleen and brain weights increased 313 and 13.5%, respectively, whereas the mean liver weight remained unchanged. In the CBA/Ca strain, cerebral cryptococcosis was the dominant clinical feature, and a 54% increase in mean brain weight was recorded at the time of death. The averaged liver weight was drastically lower, whereas spleen weight values evinced a biphasic pattern of transient splenomegaly followed by involution. At the median time of death, CBA/N mice had significantly more cryptococci in the liver and spleen than corresponding CBA/Ca mice. In the (CBA/N X CBA/Ca)F1 mice, susceptibility to C. neoformans segregated according to the sex-linked inheritance of the X-linked immunodeficiency (xid) gene. It is concluded that (i) susceptibility to cryptococcosis is under multigenic control, (ii) the xid locus on the X chromosome influences susceptibility to cryptococcosis, and (iii) xid mice behave differently than CBA/Ca mice in their organ response during the course of the infection.
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PMID:Genetic resistance to murine cryptococcosis: increased susceptibility in the CBA/N XID mutant strain of mice. 388 Jul 24

Fourteen previously healthy young patients with unusual community-acquired opportunistic infections were seen over a period of three years. They differ from patients previously described in that 11 were heterosexual drug abusers (including two women) and only three were homosexual men. There were eight Puerto Ricans, five blacks, and one white. Infections included Pneumocystis carinii pneumonia (seven), disseminated Mycobacterium intracellulare infection, histoplasmosis, cryptococcosis, and cytomegalovirus infection (one each), oral thrush (13), and Candida esophagitis (two). All patients had impaired cellular immunity manifested by cutaneous anergy and lymphopenia, and all 11 tested had a markedly decreased ratio of T helper/inducer cells to T suppressor/cytotoxic cells. Twelve had evidence of associated viral infection (Epstein-Barr virus in nine, cytomegalovirus in five, Herpes simplex type 2 in two). Clinical presentation was with a severe opportunistic infection or with a prodrome consisting of oral thrush and nonspecific findings including malaise, fever, lymphadenopathy, or cough. The syndrome of immunodeficiency and opportunistic infection occurs in nonwhite heterosexual drug abusers, not exclusively in white homosexual men, and patients may present for medical care before the onset of a severe opportunistic infection.
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PMID:Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men. 621 79

Twenty Haitian patients, hospitalized from 1 April 1980 to 20 June 1982, had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.
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PMID:Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state. 629 51

Isolated cutaneous cryptococcosis developed in a 62-year-old white man with an idiopathic deficiency of T-lymphocytes. The patient was healthy, except for the cutaneous infection, and displayed no other evidence of an immunodeficiency disorder. An immunologic workup should be conducted in all patients with cryptococcal infection, regardless of their apparent health status.
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PMID:Localized cutaneous cryptococcosis in an immunosuppressed man. 633 93

A 5-year-old female Siamese cat was presented to the veterinary teaching hospital with a history of bronchopneumonia for 20 days. The cat had not responded to antibacterial chemotherapy and had developed a pronounced submandibular lymphadenopathy. Characteristically encapsulated yeast cells with narrow-necked buds were clearly seen in a fine-needle aspirate of the lymph node with an India ink preparation. Cryptococcus neoformans var. neoformans was identified. Susceptibility tests on the isolated strain were performed using antifungal tablets. The strain was sensitive to amphotericin B, fluconazole, itraconazole and ketoconazole and was resistant to 5-fluorocytosine. The cat was positive for feline immunodeficiency virus. Nevertheless, the cat was treated with ketoconazole for 3 months and apparently recovered. Three months later the animal was presented in a precomatose state. The owners refused to treat the animal and the cat was destroyed.
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PMID:Cryptococcosis in a cat seropositive for feline immunodeficiency virus. 747 89

Amphotericin B and fluconazole are current acceptable therapies for cryptococcal meningitis; however, their effect remains suboptimal. The combination of fluconazole and flucytosine has yielded encouraging clinical results in human immunodeficiency virus patients with cryptococcal meningitis. To investigate the biological basis of this finding, we performed in vitro combination testing of fluconazole and flucytosine against 50 clinical strains of Cryptococcus neoformans var. neoformans. Synergy (fractional inhibitory concentration index of < 1.0) was observed in 62% of cases, while antagonism (fractional inhibitory concentration index of > 2.0) was not observed. For cases in which synergy was not achieved (autonomous or additive effects), the beneficial effect of the combination was still seen (i.e., there was still a decrease, although not as dramatic, in the MIC of one or both drugs when used in combination). The in vitro inhibitory action of flucytosine was greatly enhanced by the addition of fluconazole; the flucytosine MICs for Cryptococcus isolates were markedly decreased to concentrations which were severalfold lower than the achievable cerebrospinal fluid flucytosine concentration. On the other hand, the addition of flucytosine did not greatly enhance the in vitro activity of fluconazole if the initial fluconazole MIC for the isolate was > or = 8 micrograms/ml. Controlled clinical studies are warranted to further elucidate the potential utility of fluconazole-flucytosine combination therapy.
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PMID:In vitro evaluation of combination of fluconazole and flucytosine against Cryptococcus neoformans var. neoformans. 748 2

Infection with Cryptococcus neoformans occurs with increased frequency in patients with the human immunodeficiency virus (HIV). Despite the lungs being the portal of entry for the fungus the commonest presentation is with meningitis: Cryptococcal broncho pulmonary infection occurs less commonly. The chest radiographs of fourteen HIV positive patients with cryptococcal pneumonia were reviewed. The commonest radiographic abnormalities were interstitial infiltrates, (nine patients) and focal or widespread alveolar consolidation (seven patients). Ground glass shadowing, not previously described in cryptococcal pneumonia, occurred in six radiographs, miliary nodules in one, lymphadenopathy in four, and small pleural effusions in three. Two patients had a normal chest radiograph. In contrast to previous reports, we found alveolar consolidation and ground glass shadowing to be common and nodules and cavitation to be rare. Cryptococcal pneumonia should be considered in the differential diagnosis of Pneumocystis carinii pneumonia, bacterial pneumonia and miliary tuberculosis in HIV positive patients.
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PMID:Cryptococcal pneumonia in patients with the acquired immunodeficiency syndrome. 748 24

In the human immunodeficiency virus (HIV) infected patient, skin infections caused by S aureus are extremely common. Impetigo, ecthyma, and folliculitis are all seen. Recurrences are common due to a nasal carriage rate of 50%. Dermatophytosis usually manifests as tinea pedis or unguium and is caused by Trichophyton rubrum. Oral candidiasis may be the initial evidence of HIV infection, and is predictive of more rapid progression to acquired immune deficiency syndrome (AIDS). Topical agents are usually effective for oral lesions, but involvement of the esophagus requires oral imidazole therapy. Systemic fungal infections are most commonly caused by cryptococcosis or histoplasmosis. The finding of either of these infectious agents in the skin is pathognomonic of disseminated infection. Cryptococcus presents as umbilicated papules resembling molluscum or as large ulcerations. Histoplasmosis has no specific cutaneous morphology. Scabies is very common in HIV-infected persons, and once the helper T-cell count is less than 200, it may present atypically. Permethrin is the recommended treatment in this setting.
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PMID:Treatment of bacterial, fungal, and parasitic infections in the HIV-infected host. 750 36


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