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

Endobronchial scraping was used in 53 immunodeficient children, aged 4 months to 15 years, and divided into three categories (37 receiving immunosuppression treatment, 8 with marasmus, and 8 with immunodeficiency), in order to determine the etiology of their interstitial pneumopathy. The examination was made under blind conditions in 21 cases using an intubation tube (under assisted ventilation), and with bronchoscopy under general anesthesia in the other 32 cases. Three scrapings were required for cytological, bacteriological, and virological and mycological examinations. In 32 cases (60%), the etiology of the interstitial pneumopathy was discovered; in 18 patients it was due to pneumocystis carinii, in 10 cases to bacterial infection, in 7 cases a viral infection, and in 3 others a fungal infection. An association of infective agents was reported in 6 cases. The major incident observed was a pneumothorax in 17% of the cases, more especially in 45% of the children under 20 months of age. Bronchial scraping is a valid examination the results and complications of which compare well with other non-vascular methods of diagnostic evaluation of such lesions.
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PMID:[Results of bronchial scrapings in interstitial pulmonary diseases in immunodeficient children (author's transl)]. 54 12

Between 1986 and 1990 we found in 7 out of 100 continuously performed AIDS-autopsies at Auguste-Viktoria-Hospital (AVH) an extrapulmonary manifestation of Pneumocystis carinii (Pc). 4 of these cases showed only a singular infiltration of pulmohilar lymphnodi, while the remaining 3 cases presented various other organ involvements: spleen, liver, kidney, adrenal gland, prostate gland, pancreas, myocardium, thyroidea and eyes. All these AIDS-patients had a chronic or relapsing Pc-pneumonia with focal interstitial fibrosis, emphysema, and cavernous-cystic lesions. 6 patients developed a spontaneous pneumothorax due to ruptured subpleural bullae or cystic changes. Apparently the rare dissemination of Pc develops in the context of ruptured tissue and vessels in the pneumothorax lung of AIDS-patients during the final stage of the immunodeficiency associated with chronic lung changes.
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PMID:[Extrapulmonary manifestations of Pneumocystis carinii infection in AIDS]. 172 21

Three children with suppurative arthritis and osteomyelitis are described to emphasise that delayed or incorrect diagnosis may lead to serious cardiopulmonary complications. In two patients, bilateral bronchopneumonia developed with pneumatocoeles, pneumothorax and empyema. The other had cardiac failure from septic pericarditis. In one case, disarticulation of the knee was needed as a life-saving measure, and the other leg developed an infected pseudarthrosis of the tibia. The causative organism in each case was staphylococcus aureus and no evidence of immunodeficiency was demonstrated.
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PMID:Complications of suppurative arthritis and osteomyelitis in children. 174 34

Invasive aspergillosis (IA) is a rare infection in patients with the Acquired Immune Deficiency Syndrome (AIDS). We report the first Australian cases of histologically and microbiologically proven IA diagnosed antemortem in AIDS patients. We also describe the first case of laryngeal involvement and the unusual case of a pneumothorax due to IA. These three cases illustrate the varied clinical and pathological features of IA in AIDS and highlight some of the difficulties in diagnosis and treatment. The infections occurred in the setting of advanced immunodeficiency and multiple opportunistic infections and responded poorly to treatment.
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PMID:Invasive aspergillosis in AIDS. 175 26

The authors describe the case of a 24-year-old woman with valve disease. After a bout of respiratory tract infection, she was diagnosed to have bacterial endocarditis associated with mitral valve disease. The causative agents isolated included Eikenella corrodens, Streptococcus intermedius, Bacteroides oralis and Bacteroides bivius. At the same time, the patient was found to have developed IgA immunodeficiency. A complication accompanying the cardiac disease was spontaneous pneumothorax. Since antibiotic therapy had failed, the mitral valve was replaced by a prosthetic one. After the procedure, the patient had her teeth examined. The examination revealed complete destruction of tooth 36, thick layers of calculus and chronic gingivitis. E. corrodens was isolated also after microbiological examination of the patient's oral cavity. The reason for reporting on what we regard as an interesting case is that bacterial endocarditis with E. corrodens implicated as the causative agent is relatively rare; to date, polymicrobial endocarditis due to E. corrodens and other microorganisms has been described in intravenous drug addicts only.
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PMID:Eikenella corrodens infection of the oral cavity as a cause of bacterial endocarditis. 219 Jul 61

Spontaneous pneumothorax is a known complication of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. To evaluate the possible pathogenesis and natural history of pneumothorax in patients receiving aerosolized pentamidine prophylaxis, we retrospectively reviewed 327 outpatients positive for human immunodeficiency virus receiving aerosolized pentamidine. There were 12 spontaneous pneumothoraces in this group of patients. Seventy-five percent of patients with pneumothorax had roentgenographic evidence of fibrocystic lung parenchyma and clinical evidence of active Pneumocystis pneumonia. The majority (83%) required chest tube evacuation. There was a 50% mortality rate associated with this complication. These findings suggest that spontaneous pneumothorax in patients treated with aerosolized pentamidine most commonly represents a prophylaxis failure associated with a high mortality rate.
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PMID:Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome treated with prophylactic aerosolized pentamidine. 222 2

Suramin sodium is a reverse transcriptase inhibitor with in vitro activity against the human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS). Ninety-eight patients with AIDS manifest as opportunistic infections (n = 38), AIDS with Kaposi's sarcoma (n = 38), AIDS-related complex (n = 20), or AIDS-associated non-Hodgkin's lymphoma (NHL) (n = 2) were treated with suramin sodium at 0.5, 1.0, or 1.5 g/wk for six weeks followed by maintenance therapy with 0.5 or 1.0 g/wk. Of 72 patients who were HIV culture positive before therapy and were assessable for subsequent HIV culture 40% became culture negative during treatment, with no apparent correlation between virus recovery and serum suramin concentration. No immunologic improvement was noted. One complete clinical remission was noted in a patient with Kaposi's sarcoma and stage IV NHL. Seven minor clinical responses were also noted. Toxic reactions were generally reversible, and included fever (78%), rash (48%), malaise (43%), nausea (34%), neurologic symptoms (33%), and vomiting (20%). Suramin-induced neutropenia was noted in 26%, thrombocytopenia in 12%, a serum creatinine level of 180 mumol/L or higher (greater than or equal to 2.1 mg/dL) in 12%, liver dysfunction in 14%, and clinical and/or laboratory evidence of adrenal insufficiency in 23%. Sixteen patients died while receiving suramin or within three weeks of discontinuation of drug therapy due to infection (n = 6), hepatic failure (n = 3), pulmonary Kaposi's sarcoma (n = 2), AIDS encephalitis (n = 2), AIDS-associated NHL (n = 1), iatrogenic hemo-pneumothorax (n = 1), or pulmonary disease of uncertain etiology. Suramin as currently administered cannot be recommended as effective therapy for AIDS.
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PMID:Suramin therapy in AIDS and related disorders. Report of the US Suramin Working Group. 365 Mar 39

Surgical consultation is regularly requested for diagnosis and treatment of pulmonary complications of the endemic mycosis, Histoplasma capsulatum, Blastomyces dermatitidis and Coccidioidomycosis immitis, and the yeast Cryptococcus neoformans. All resemble pulmonary malignancies. Histoplasmosis causes pericarditis, mediastinal fibrosis and mediastinal granuloma, which can cause entrapment of vascular structures, the esophagus, and the trachea. Coccidioidomycosis can cause spontaneous pneumothorax and thin wall cavities that can be superinfected with tuberculosis and Aspergillosis. The pathogenesis, diagnosis, and treatment of these organisms are discussed with emphasis on the new oral therapies and complications encountered in persons with human immunodeficiency virus (HIV) infection.
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PMID:The endemic mycoses: surgical considerations. 761 61

The records of 97 patients with thoracic complications of human immunodeficiency virus (HIV) were analysed to determine the reasons for surgery and the results of these procedures. Of the patients, 79 underwent surgery; the remaining 18 were managed non-surgically. A total of 36 procedures were performed for diagnostic purposes: mediastinoscopy (21 patients), lung biopsy (15 patients). Therapeutic procedures were performed in 61 patients to treat pneumothorax (23 cases) or empyema thoracis (18 cases), for resection of pulmonary lesions (13 cases), and to treat various other pathologies (seven cases). Ten patients died in hospital: seven after surgery and three after a nonsurgical procedure. Eleven patients developed a postoperative complication. Hospital mortality varied from 0 per cent to 20 per cent, depending on the procedure. The mortality rate appears to be linked to the stage of HIV infection at the time of therapy rather than to the type of procedure performed. Surgical decisions must take into account the patient's Centers for Disease Control stage and physiological status, therapeutic possibilities, and the prognosis of the pathology requiring treatment.
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PMID:Surgical management of thoracic manifestations in human immunodeficiency virus-positive patients: indications and results. 788 53

A 35-year-old male homosexual, a former intravenous drug abuser, was found to be human immunodeficiency virus (HIV) positive in 1984. He developed AIDS in 1987 and began treatment with zidovudine in 1989. One year later he developed left apical pleural blebs, a pneumothorax and an exudative pleural effusion. A malignant mesothelioma developed at the pleural blebs in the left apex. He was treated with adriamycin but rapid progression of the malignancy occurred and he died three months later. At autopsy, a malignant mesothelioma, causing respiratory failure and death, was found. The patient had no exposure to asbestos and asbestosis was not present at autopsy. We postulate that the development of malignant mesothelioma was probably related to HIV immune suppression or HIV and/or cytomegalovirus or zidovudine and is a complication of AIDS similar to the development of other malignant neoplasms in patients with AIDS.
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PMID:AIDS and malignant mesothelioma--is there a connection? 813 80


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