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Query: UMLS:C0021051 (
immunodeficiency
)
71,517
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A previously healthy woman had a febrile illness resembling aseptic meningoencephalitis. With the exception of mild increase in both CSF pressure and protein concentration, initial findings were normal, including negative bacterial cultures. Bilateral pyramidal and cerebellar signs with multiple lower cranial nerve pareses developed over a 48-hour period beginning on the tenth hospital day. Repeated blood and CSF studies had previously been nondiagnostic, but at that time, cultures became positive for Listeria monocytogenes. No underlying
systemic disease
or
immunodeficiency
was discovered. With appropriate antibiotic and supportive therapy, she made slow but significant improvement and, by the time of discharge from the hospital, had only minimal residual neurologic deficit. Clinical aspects of CNS listeriosis including the rare pontomedullary involvement are discussed.
...
PMID:CNS listeriosis: rhomboencephalitis in a healthy, immunocompetent person. 50 67
Infections with Geotrichum species, although rare, are sometimes seen in immunocompromised hosts. We report a case of oral geotrichosis in a patient seropositive for human
immunodeficiency
virus who had erythematous mandibular and maxillary gingiva but was otherwise free of any active
systemic disease
. Geotrichum candidum was shown by both culture and histopathology to be present in the lesion and was deduced to be the causative organism. The patient responded well to several weeks of treatment involving oral topical administration of nystatin vaginal tablets.
...
PMID:Oral Geotrichum candidum infection associated with HIV infection. A case report. 143 44
Intravenous immunoglobulin (IVIG) therapy has been used not only as replacement treatment for
immunodeficiency
, but also as treatment of autoimmune diseases, specifically Kawasaki disease, systemic juvenile arthritis and juvenile dermatomyositis. In Kawasaki disease, IVIG reduces the incidence of coronary artery abnormalities, as well as rapidly improving clinical and laboratory variables such as fever and rash, platelet count, white blood cell count and serum albumin. Furthermore, a single high dose of 2 g/kg is as effective as 400 mg/kg x 4 days. In systemic juvenile arthritis, followup of at least one year demonstrated that monthly treatment with IVIG resulted in improvement of
systemic disease
in 10/11 patients, allowed for cessation of prednisone treatment in 7/8 patients and significant improvement of arthritis in 8 patients. In juvenile dermatomyositis, we report 2 uncontrolled trials of IVIG treatment that resulted in significant clinical improvement and steroid-sparing. In contrast, IVIG treatment of systemic lupus erythematosus (SLE) resulted in improvement in 3 patients, but exacerbation or new onset of renal disease in 3 patients. Overall, our report demonstrates that IVIG has been effective both in a controlled trial in Kawasaki disease and in uncontrolled trials in systemic juvenile arthritis and juvenile dermatomyositis. We suggest that IVIG should be used cautiously in SLE.
...
PMID:Intravenous immunoglobulin therapy: magic or black magic. 801 61
Visible plaque index (VPI), gingival bleeding index (GBI) and pocket depth (PD) were analyzed in relation to potential periodontal pathogenic microorganisms and peripheral numbers of T4+ and T8+ lymphocyte subsets in 10 patients with human
immunodeficiency
virus (HIV) infection, 10 patients with AIDS related complex (ARC) and 10 patients with acquired immune deficiency syndrome (AIDS). 10 healthy persons served as controls. Periodontal disease in patients with more advanced stages of HIV infection were related to the severity of the
systemic disease
, and to decreasing numbers of T4+ lymphocytes in peripheral blood, but not to VPI or the occurrence of periodontal pathogenic micro-organisms.
...
PMID:Periodontal disease in HIV-infected patients in relation to lymphocyte subsets and specific micro-organisms. 167 65
Bacillary angiomatosis is an opportunistic infection with systemic manifestations. Although most cases have occurred in human
immunodeficiency
virus-positive patients, other immunosuppressed patients, and even seemingly immunocompetent individuals, can become infected. In addition to the well-characterized cutaneous manifestations, visceral involvement can occur and may be the only locus of infection. Lymphadenopathy, bone or soft-tissue masses, fever, and hepatosplenomegaly can be presenting signs. The causative bacterium is still unidentified, but resemblances to the rickettsiae, Rochilamea quintana, the recently identified cat-scratch disease bacillus, and Bartonella bacilliformis have been noted by various investigators.
Systemic disease
is treatable and can be cured with antibiotic therapy.
...
PMID:Bacillary angiomatosis: a systemic opportunistic infection with prominent cutaneous manifestations. 193 68
The AIDS dementia complex (ADC) is one of the most common and important causes of morbidity associated with infection by human
immunodeficiency
virus type 1 (HIV-1). The evaluation of ADC in clinical trials is significant not only because of the clinical impact of this syndrome, but also because of the value of measuring its cardinal features as an index of drug efficacy and because of its emerging role as a major clinical end point. The objectives of therapy include both prevention of ADC in the presymptomatic patient and alleviation of established disease. At present, the pathogenesis of ADC is incompletely understood in several critical aspects, particularly the processes underlying the clinical manifestations of central nervous system (CNS) HIV-1 infection and, further, how such processes are related to
systemic disease
. Consequently, it is not yet clear to what extent, or in which patients, it is necessary to achieve "therapeutic" drug levels within the CNS. Nevertheless, the assessment of ADC prevention and treatment relies principally on the complementary approach of neurological examination for diagnosis and neuropsychological testing for quantitative serial measurement of treatment effects. Additionally, surrogate markers in cerebrospinal fluid (CSF) may hold promise for objective, rapid assessment of treatment response and dose adjustment. Other measurements, including more routine CSF analysis, neuroimaging, and neurophysiological assessments, are used principally for differential diagnosis rather than for monitoring ADC status. Accumulating experience with available antiviral agents suggests that ADC can be effectively prevented and treated, at least for some period of time, and that assessment of this condition is indeed a valuable approach for measuring antiviral therapy.
...
PMID:Evaluation of the AIDS dementia complex in clinical trials. 223 3
Tuberculosis has now been well documented as a complication of infection with human
immunodeficiency
virus (HIV), but no studies concern patients requiring admission to the ICU. We report 12 cases of severe disseminated tuberculosis in patients who were seropositive for HIV. Eight patients had diffuse pulmonary involvement responsible for acute respiratory failure, 7 of whom required mechanical ventilation. Four developed septic shock, and in 3 blood cultures were positive for M. tuberculosis. Four patients had central nervous system involvement, with coma requiring mechanical ventilation 3 times. Rapid diagnosis was permitted in 10 patients by acid-fast smears of pulmonary specimens (8 patients) and/or tissue biopsies (4 patients). Seven patients died despite intensive therapy; autopsy was performed in 4 patients, showing disseminated tuberculosis. On the basis of this report, tuberculosis in HIV infection may present as an overwhelming
systemic disease
and thus requires an aggressive diagnostic and therapeutic approach.
...
PMID:Severe tuberculosis in patients with human immunodeficiency virus infection. 228 26
Cystic enlargement of the parotid gland is a newly described manifestation of infection with human
immunodeficiency
virus (HIV). A review of 15 such patients with respect to clinical presentation, natural history, and management is presented. Follow-up ranges from 1 to 27 months, averaging 10 months. In 47% of the patients, parotid swelling was the chief complaint leading to the diagnosis of HIV infection. T-cell analysis revealed the tendency for this lesion to occur in the early stages of
immunodeficiency
when T-cell counts are high. Histologic examination revealed findings resembling benign lymphoepithelial lesion. It is felt that these lesions are a local manifestation of a
systemic disease
and treatment should be tailored with this in mind. Surgical excision may not be necessary. Fine-needle aspiration (FNA) was found to be useful diagnostically and therapeutically. Recognition of this entity is essential for the head and neck specialist in providing an early diagnosis of HIV infection.
...
PMID:Cystic parotid masses in HIV infection. 236 65
About half of the general population harbors Candida species in oral flora, and oral candidal infections are common. However, in immunocompromised or immunosuppressed patients, candidiasis may progress to life-threatening
systemic disease
. Patients with human
immunodeficiency
virus (HIV), acquired immunodeficiency syndrome, HIV disease, diabetes, or leukemia are particularly prone to serious systemic infection. Chemotherapy for cancer and bone marrow and organ transplantation also provide physiologic opportunities for candidal colonization. Topical therapy has the potential to prevent and treat candidiasis with less risk of side effects and drug interactions than systemic therapy. Among the effective topical agents are polyene antifungal antibiotics and imidazole compounds. Some of these agents have been found useful in prevention of serious candidal infection in high-risk patients; however, more study is needed in this area.
...
PMID:Oral and pharyngeal candidiasis. Topical agents for management and prevention. 264 72
The mycobacteria are an important group of acid-fast pathogens ranging from obligate intracellular parasites such as Mycobacterium leprae to environmental species such as M. gordonae and M. fortuitum. The latter may behave as opportunistic human pathogens if the host defenses have been depleted in some manner. The number and severity of such infections have increased markedly with the emergence of the acquired immunodeficiency syndrome (AIDS) epidemic. These nontuberculous mycobacteria tend to be less virulent for humans than M. tuberculosis, usually giving rise to self-limiting infections involving the cervical and mesenteric lymph nodes of young children. However, the more virulent serovars of M. avium complex can colonize the bronchial and intestinal mucosal surfaces of healthy individuals, becoming virtual members of the commensal gut microflora and thus giving rise to low levels of skin hypersensitivity to tuberculins prepared from M. avium and M. intracellulare.
Systemic disease
develops when the normal T-cell-mediated defenses become depleted as a result of old age, cancer chemotherapy, or infection with human
immunodeficiency
virus. As many as 50% of human
immunodeficiency
virus antibody-positive individuals develop mycobacterial infections at some time during their disease. Most isolates of M. avium complex from AIDS patients fall into serotypes 4 and 8. The presence of these drug-resistant mycobacteria in the lungs of the AIDS patient makes their effective clinical treatment virtually impossible. More effective chemotherapeutic, prophylactic, and immunotherapeutic reagents are urgently needed to treat this rapidly increasing patient population.
...
PMID:Mycobacterial disease, immunosuppression, and acquired immunodeficiency syndrome. 268 57
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