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

International guidelines recommend resistance testing of maternal virus for all human immunodeficiency virus (HIV)-infected pregnant women. The use of highly active antiretroviral therapy leads to maximal virologic suppression, thus minimizing the risk of drug resistance, but it is available only in developed countries. In developing countries, the use of short-course regimens is becoming more widespread. Women infected with HIV may be at greater risk for complications during pregnancy, including ectopic pregnancy, early abortions, bacterial pneumonia, urinary tract infection, oral and recurrent vaginal thrush, malaria, and tuberculosis. Regional anesthesia is often the treatment of choice when administering anesthesia in an HIV-infected pregnant woman. Infected children present decreased survival rates, while uninfected children born to infected mothers present a higher incidence of poor weight gain, short stature, and wasting than would be expected for the general population. Transmission of HIV-1 can occur via breast-feeding.
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PMID:AIDS in pregnancy, part II: Treatment in the era of highly active antiretroviral therapy and management of obstetric, anesthetic, and pediatric issues. 1736 96

Pseudomonas aeruginosa is a pathogen that often infects patients who are either immunocompromised or have local defects in host defences. It is known that cystic fibrosis (CF) patients are sometimes infected with certain clonal isolates. It is not clear whether these clonal isolates also infect non-CF patients and whether clonality of isolates occurs in other patient groups. The aim of this study was to investigate P. aeruginosa diversity and the occurrence of clones within five distinct paediatric patient groups susceptible to P. aeruginosa infection. P. aeruginosa isolates were cultured from 157 patients (CF first infection (CF-1 group) (29); CF chronic infection (CF-chronic group) (27); urinary tract infection (34); chronic suppurative otitis media (43); and intensive-care hospitalization/immunodeficiency (24)). All 202 phenotypically different isolates were tested for antimicrobial resistance and further typed by pulsed-field gel electrophoresis. Simpson's diversity index was calculated for the five groups. CF-chronic patients carried the highest number of distinct P. aeruginosa phenotypes and genotypes per culture. Isolates from the CF-chronic group were significantly less diverse than those from the other groups. A group of clonal isolates was observed among patients from the CF-chronic and CF-1 groups. These or different clonal isolates were not encountered among the three other patient groups. No characteristic resistance pattern could be identified among isolates from the distinct patient groups and among the clonal isolates. In conclusion, isolates of the CF-chronic group were less diverse than those in the other patient groups with P. aeruginosa infection; clonal isolates were not encountered in non-CF patients. Transmission of clonal CF isolates to other patient groups was not observed.
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PMID:Pseudomonas aeruginosa diversity in distinct paediatric patient groups. 1875 96

This article reviews the literature regarding the possible correlation between infection and occurrence of bladder cancer. The PubMed literature database was searched from inception to January 2008. Keywords of bladder, cancer, parasitic, bacterial, viral and infection, were used. Forty studies were included in the review. Several investigators support the idea that schistosomiasis is aetiologically related to the development of bladder cancer in individuals infected with Schistosoma haematobium. Approximately 70% of those with chronic schistosomiasis who have bladder cancer develop squamous cell rather than transitional cell carcinoma. Several investigators suggest that bacteria may play a role in inducing bladder cancer. Clinically, researchers have linked the development of infection, urinary stones and indwelling catheters with bladder cancer. Nevertheless, to date, no prospective study has examined the association between urinary tract infection and bladder cancer risk. The possibility that infection by human papilloma virus (HPV) is a risk factor contributing to bladder cancer has been investigated but no definite conclusions have been drawn. Thus, the debate remains open as to whether there is any direct link between chronic HPV infection and bladder cancer. Only 15 cases of vesical carcinoma have been reported, to date, in the setting of human immunodeficiency virus (HIV). The rare occurrence of bladder cancer during HIV infection and the lack of correlation with the laboratory markers of HIV disease progression may suggest a trivial association between two unrelated disorders. BK virus is oncogenic in newborn hamsters and can transfer to mammalian cells in vitro, but there is little consistent evidence of a link with human bladder cancer. Studies showed no correlation between herpes simplex virus (HSV) and bladder cancer, but bladder cancer becomes infected with HSV much more easily than non-neoplastic urothelium. In conclusion, with the exception of chronic infection with S. haematobium, the association between the occurrence of bladder cancer and chronic bacterial or viral infections could not be confirmed. Prospective studies with large numbers of patients and controls are required to confirm this issue.
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PMID:Infection: is it a cause of bladder cancer? 1881 20

Tuberculosis (TB) is one of the major health problems that our country is facing today. Despite active interventions by our government, control of TB still remains to be achieved. The emergence and exponential growth of the human immunodeficiency virus and drug-resistant strains threaten to further complicate the TB situation in our country. Even in this era of advanced chemotherapy, many lives are lost every day in our country. Tuberculosis of the urinary tract, despite being one of the commonest forms of extra-pulmonary TB, is generally overlooked. Most patients present with vague lower urinary symptoms typical of urinary tract infection. In this article, we shall highlight the various issues related to the surgical management of renal and ureteral tuberculosis.
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PMID:Surgical management of renal tuberculosis. 1946 71

Emphysematous cystitis is a rare disorder that is usually associated with immunosuppression, poorly controlled diabetes mellitus, and other risk factors such as previous urinary tract infection and/or recent instrumentation of the urinary tract. The case of an 89-year-old woman with emphysematous cystitis who had no evidence of immunodeficiency or other risk factors except for advanced age is reported. A review of the literature on emphysematous cystitis in immunocompetent, nondiabetic individuals is presented.
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PMID:Emphysematous cystitis in the absence of known risk factors: an unusual clinical entity. 1966 51

Musculoskeletal infections in children present a diagnostic challenge because they are difficult to recognize in the early stages of the disease and can be confused with other pathology such as tumors or trauma. The severity of disease may be associated with the primary tissue of involvement with bone greater than joint, greater than muscle, greater than soft tissue. The incidence of musculoskeletal infection is higher in infants and young children, and risk factors include premature birth, umbilical catheterization, urinary tract infection, immunodeficiency, and other preexisting disease. Neonates are at greater risk for infection with less virulent organisms due to immaturity of the immune system. The epidemiology of musculoskeletal infection is evolving, and the incidence of musculoskeletal infections in children, especially gram-positive infections, are increasing. Staphylococcus aureus continues to be the leading cause of musculoskeletal infection in children, and the emergence of resistant bacteria such as methicillin-resistant S. aureus is associated with a higher rate of complications. Atypical infections such as tuberculosis have also shown resurgence in the last few decades, whereas other infections such as Haemophilus influenzae are much less prevalent due to widespread immunization. Recent advances in earlier diagnosis and treatment help to reduce complications. However, even when musculoskeletal infection is successfully treated, there may be significant long-term effects on growth.
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PMID:Imaging of pediatric musculoskeletal infection. 1972 94

The impact of human immunodeficiency virus (HIV) infection and CD4+ count on the prevalence of urinary tract infection (UTI) is studied to determine the prevalence of UTI among HIV and non-HIV subjects. Clean-catch midstream urine and venous blood was collected from 421 subjects comprising 317 HIV patients (89 men, 228 women) and 104 non-HIV subjects (48 men, 56 women). The HIV patients consisted of 101 highly active antiretroviral therapy (HAART)-naive subjects and 216 patients on HAART for three to six months. The HIV patients were asymptomatic and all subjects had no signs or symptom of UTI. Microbial isolates were identified in urine and susceptibility tests were performed. Only HIV patients on HAART had significantly higher prevalence of asymptomatic UTI compared with non-HIV subjects (27.78% vs. 17.31%, OR = 1.8376, 95% confidence interval = 1.0198-3.3112, P = 0.0411). Among both groups, CD4+ count < 200 cells/microL was not associated with asymptomatic UTI. Staphylococcus aureus was the most common uropathogen (27.2%) and nitrofurantoin was the most active antibacterial agent. Most bacterial isolates were resistant to other antibacterial agents used (amoxicillin, amoxicillin-clavulanate, gentamicin, co-trimoxazole, tetracycline, nalidixic acid, ciprofloxacin and ofloxacin). Overall prevalence of asymptomatic UTI was 24.94%. HIV patients on HAART had a one- to three-fold higher risk of acquiring UTI. CD4+ count was not associated with asymptomatic UTI.
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PMID:Urinary tract infection among asymptomatic HIV patients in Benin City, Nigeria. 2009 27

Hyper-IgE syndrome, also known as Job's syndrome, is a rare primary immunodeficiency that was first described in 1966. This syndrome is associated with an increased risk for malignancies. Here, we report an 18-year-old woman who was frequently hospitalized since childhood because of recurrent pneumonia and urinary tract infection. Multiple erythematous papules and nodules with ulceration were found on her face and right forearm. A skin biopsy showed angiocentric and angiodestructive atypical lymphoid infiltration. In situ hybridization revealed latent Epstein- Barr virus-infected lymphoid cells. Accordingly, this indicates that Epstein-Barr virus infection may have induced the extranodal natural killer/T cell lymphoma in this patient with hyper-IgE syndrome.
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PMID:Hyper-IgE syndrome with Epstein-Barr virus associated extranodal NK/T cell lymphoma of skin. 2043 2

Primary immunodeficiency disease (PID) is a rare disorder in adults. Most often, serious forms are detected during infancy or childhood. However, mild forms of PID may not be diagnosed until later in life, and some types of humoral immunodeficiency may occur in adulthood. The purpose of this study was to identify clinical features of PID in Korean adults. A retrospective study was performed on 55 adult patients who were diagnosed as PID between January 1998 and January 2009 at a single tertiary medical center in Korea. IgG subclass deficiency was the most common phenotype (67%, 37/55), followed by total IgG deficiency (20%, 11/55), IgM deficiency (7%, 4/55), common variable immunodeficiency (2%, 1/55), and X-linked agammaglobulinemia (2%, 1/55). IgG3 and IgG4 were the most affected subclasses. Upper and lower respiratory tract infections (76%) were the most frequently observed symptoms, followed by multiple site infection (11%), urinary tract infection, and colitis. Bronchial asthma, rhinitis, and several autoimmune diseases were common associated diseases. IgG and IgG subclass deficiency should be considered in adult patients presenting with recurrent upper and lower respiratory infections, particularly in those with respiratory allergies or autoimmune diseases.
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PMID:Immunoglobulin G subclass deficiency is the major phenotype of primary immunodeficiency in a Korean adult cohort. 2051

A 52-year-old Caucasian man presented to hospital with confusion and was treated for a urinary tract infection. He developed new and unexpected signs and symptoms during his stay in hospital. On further questioning, the story of his social background unfolded and, following further investigation, he was diagnosed with human immunodeficiency virus (HIV). This case reminds all clinicians to think about HIV in the older patient and it also gives direction for investigation and management of similar cases in the future. Identifying HIV early is imperative because it allows effective treatment to be initiated and this will impact upon the patient's quality and longevity of life.
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PMID:A patient carrying HIV. 2168 17


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