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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The acute aseptic meningitis syndrome is an entity that presents a diagnostic challenge to the clinician. Although many infectious and noninfectious etiologies exist for this syndrome, viruses, especially nonpolio enteroviruses, are the classic and most important agents encountered. The incidence of polio and mumps meningitis has declined dramatically in the vaccine era, but recently described pathogens, such as human immunodeficiency virus and Borrelia burgdorferi (Lyme disease agent) are now important considerations in the differential diagnosis. Specifically treatable entities (eg, mycobacterial or fungal meningitis, herpes simplex encephalitis, parameningeal infection) that may mimic aseptic meningitis in their initial presentations must not be overlooked. A careful approach to the patient and a rational use of laboratory studies are the basis for establishing a specific diagnosis and assuring a favorable outcome.
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PMID:The acute aseptic meningitis syndrome. 227 91

Lyme disease is of interest to the neurologist and neuroscientist for a variety of reasons. As more arthropod hosts throughout the world are infected with the causative organism, Borrelia burgdorferi, the illness in humans is becoming more prevalent; in addition, recognition of the disease in humans and susceptible animals is increasing. The neurological manifestations include acute and chronic forms, and it has become clear that B. burgdorferi has joined Treponema pallidum, herpes simplex virus, and human immunodeficiency virus (HIV) as an agent of persistent infection of the brain. Recent strides in the understanding of antigenic variation in Borrelia have provided insights into how this agent may survive in the human host. Preliminary work in animal models has provided information about the relationships between strain-dependent tropisms, spirochetemia, the development of specific antibody, and nervous system invasion. Finally, the history of the development of understanding of the disease has been a fascinating mixture of parental concern, serendipitous discovery, and correlation of clinical syndromes and serological evaluations across continents.
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PMID:Lyme disease. 247 90

Diagnosis of intraocular inflammations can be difficult, particularly if the patient is suffering from immunodeficiency. Among the endogenous inflammations this applies mainly to cases of hyaloretinitis caused by Candida or other fungi, often presenting as an acute hyalitis with sudden onset; the various ocular complications of AIDS, especially those due to toxoplasmosis (rare) and cytomegalovirus, and lyme disease, which can occasionally cause chronic panuveitis. Among the exogenous cases it applies to postoperative and posttraumatic endophthalmitis. In all these cases the diagnosis has to be established clinically if possible, since, as a consequence of the immunodeficiency, serology is hardly helpful, and only biopsy (of the vitreous) may provide additional information. Rapid diagnosis is very important because of the urgent need for therapy.
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PMID:[Sense and nonsense of examinations in hematogenous and exogenous intra-ocular infections]. 266 27

We have studied the cross-reaction with Borrelia burgdorferi of sera positive for leptospirosis, syphilis, or human immunodeficiency virus by using the microimmunofluorescence test (micro-IF). The percentage of sera reactive in the micro-IF before absorption varied from 7 to 37% and was reduced to 3 to 8% after absorption with a commercial Reiter treponemal antigen. The cross-reaction of sera positive for syphilis or human immunodeficiency virus was distinguished from the homologous reaction with sera from patients with Lyme disease in the immunoblot test results. However, the cross-reaction could not always be distinguished from the homologous reaction with sera from patients with leptospirosis whose sera scored positive in the micro-IF for B. burgdorferi.
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PMID:Cross-reaction with Borrelia burgdorferi antigen of sera from patients with human immunodeficiency virus infection, syphilis, and leptospirosis. 268 16

A survey of the members of the Canadian Infectious Disease Society was carried out to determine the content of an infectious diseases consultative practice in the 1990s. Respondents were asked to identify all new inpatient, outpatient, and telephone consultations during a 1-week period in 1990. Consultations were categorized by the infectious disease syndrome of the patient and by the microorganism that was identified. Bacterial infections were the most common cause of inpatient consultations, while viral infections were more common in outpatients. Consultations for parasitic infections were primarily for Pneumocystis carinii pneumonia related to infection with the human immunodeficiency virus (HIV). "Newer" infectious disease syndromes such as chronic fatigue syndrome, toxic shock syndrome, and Lyme disease were all represented in the responses for the 1-week study period. The significant impact of HIV infection on the overall consultative load suggests that there will be a continuing need for newly trained infectious disease consultants into the 21st century.
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PMID:The practice of infectious diseases in the 1990s: the Canadian experience. 774 32

The epidemic of acquired immunodeficiency disease [AIDS] has focused interest on the origins of "new" infectious agents. Great plagues are well known from the distant past, but a number of novel diseases affecting the nervous system infections have emerged in recent years. The causes of such new disorders are diverse: whereas rapid mutations of microbes allow the evolution of truly novel agents, the appearance of new diseases is more often due to changes in human or vector populations or changes in societal mores that result in dissemination of preexistent microbes. Examples of recently emerging infections that involve the nervous system include the enterovirus 70 epidemics with poliomyelitis-like disease, the appearance of California virus encephalitis in the midwestern United States, the rapid spread of Lyme disease with its many neurological complications in the eastern United States, and the outbreak of bovine spongiform encephalopathy in the United Kingdom, in addition to the devastating epidemic of human immunodeficiency virus (HIV), which will cause nervous system disease in over half of those infected. As the world population increases and modern transportation brings us closer into a "global village" more new agents will emerge and more will be sustained. Knowledge of the molecular biology and ecology of the agents and awareness of how our actions can alter their behavior are our best defense.
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PMID:The Soriano Award Lecture. Emerging infections of the nervous system. 793 18

Viral and other exotic diseases may be transmitted by blood transfusion. These infections include human immunodeficiency virus (HIV), hepatitis viruses (A, B, C, D and E), syphilis, malaria, retrovirus HTLV-1, and cytomegalovirus. Other more exotic diseases which may be transmitted by transfusion of blood or blood components include Chagas' disease (Trypanosomiasis cruzi), Lyme disease (Borrelia burgdorferi), and Jakob-Creutzfeldt disease. Screening procedures currently used in Australian blood banks minimise transfusion-transmitted infection. The risk of acquiring any infection in this manner may be less than 0.1%.
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PMID:Transfusion transmitted infection: viral and exotic diseases. 844 2

There is increasing evidence that lipoproteins of Treponema pallidum and Borrelia burgdorferi are key inflammatory mediators during syphilis and Lyme disease. A principal objective of the present study was to identify more precisely similarities and divergences among lipopolysaccharide (LPS)- and lipoprotein-lipopeptide-induced immune cell signaling events. Like LPS, purified native B. burgdorferi OspA and synthetic analogs of OspA, OspB, and two T. pallidum lipoproteins (Tpp47 and Tpp17) all induced NF-kappa B translocation in THP-1 human monocytoid cells. Acylation of OspA and the synthetic peptides was requisite for cell activation. Polymyxin B abrogated only the response to LPS. By using 70Z/3-derived pre-B-cell lines either lacking or expressing human CD14 (the LPS receptor), it was observed that expression of human CD14 imparted responsiveness to LPS but not to OspA or spirochetal lipopeptides (assessed by induction of NF-kappa B and expression of surface immunoglobulin M). Finally, the biological relevance of the observation that T. pallidum lipoproteins-lipopeptides induce both NF-kappa B and cytokine production in monocytes was supported by the ability of the synthetic analogs to promote human immunodeficiency virus replication in chronically infected U1 monocytoid cells; these observations also suggest a potential mechanism whereby a syphilitic chancre can serve as a cofactor for human immunodeficiency virus transmission. The combined data lend additional support to the proposal that spirochetal lipoproteins and LPS initiate monocyte activation via different cell surface events but that the signaling pathways ultimately converge to produce qualitatively similar cellular responses.
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PMID:Activation of human monocytic cells by Treponema pallidum and Borrelia burgdorferi lipoproteins and synthetic lipopeptides proceeds via a pathway distinct from that of lipopolysaccharide but involves the transcriptional activator NF-kappa B. 875 37

The timely facilitation of immunologic (immunoglobulin or vaccine) or antimicrobial prophylaxis is used in individuals who have been exposed to certain infectious diseases. Such methodology has been shown to be helpful in infections such as viral hepatitis types A and B, measles, varicella, rabies, and tuberculosis. The data supporting such use in rubella and mumps are not strong and information is still needed in hepatitis C, human immunodeficiency virus, and Lyme borreliosis. This article reviews postexposure prophylaxis in these situations. Preventive strategies for meningococcal disease, group A streptococcus, tetanus, diphtheria, and pertussis are discussed elsewhere in this issue.
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PMID:Postexposure prophylaxis. 895 74

The current status and future prospects of vaccines for adults are discussed. For every child in America who dies of a vaccine-preventable disease, about 400 adults die of such a disease. Evidence of the merit of influenza vaccination continues to accumulate, yet < 30% of high-risk people younger than 65 have been vaccinated. Use of pneumococcal vaccine lags behind that of influenza vaccine. Serious discrepancies in immunization levels exist among different segments of U.S. adult society. A vaccination status assessment is now recommended for everyone reaching the age of 50. New vaccines are available to prevent varicella, hepatitis A, and typhoid fever. There are now two formulations of hepatitis A virus vaccine; adult users of these vaccines include travelers, people relocating to areas with poor sanitation, military personnel, laboratory workers, and hemophiliacs. New rabies vaccines may be the next vaccines to be used primarily in adults. Vaccines against pertussis, Lyme disease, cholera, herpes simplex, malaria, other infectious diseases, and cancer are in various stages of development. For health care personnel in areas where there is a strong likelihood of Mycobacterium tuberculosis transmission and infection, BCG vaccination is recommended. The risk of immunization to a person infected with the human immunodeficiency virus is likely outweighed by the protection offered against other health threats. Health systems should select tetanus-diphtheria toxoids adsorbed for their formularies for immunizing adults, not monovalent tetanus toxoid. Vaccines are available to prevent a growing list of infectious diseases but are underused in adults.
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PMID:Status and future of vaccines for adults. 904 59


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