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)

Mycobacterium gordonae is frequently isolated from urine, but M gordonae genitourinary disease is rare; the majority of the isolates are commensals. We describe a 40 year old housewife who presented with loin pain, dysuria and frequency. Urine contained excessive pus cells, was sterile on culture and she did not respond to broad spectrum antibiotics. There was repeated isolation of M gordonae from the urine and she responded to a standard antituberculosis regimen. She was irregular and non-compliant with supervised therapy and relapsed three months after stopping medications. She again had symptoms and M gordonae was repeatedly isolated from the urine, Mycobacterium tuberculosis and other pathogens were not isolated. There was no evidence of humoral or cellular immunodeficiency or HIV infection.
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PMID:Mycobacterium gordonae genitourinary disease. 154 12

To identify epidemiologic and clinical patterns associated with human immunodeficiency virus (HIV) infection in sexually transmitted disease (STD) patients in Nigeria, serologic testing was performed on 581 men and women seen at Ibadan's Special Treatment Clinic during 1989-90. Of these, 37 (6.4%) were confirmed HIV-positive; 21 (3.6%) had HIV-1 antibodies and the remaining 16 (2.8%) had HIV-2 antibodies. Peak HIV incidence (24 cases, or 65%) was in the 21-30 year age group; the male to female ratio was 1.01 to 1.00. Presenting symptoms in HIV-positive cases included urethral discharge, vaginal discharge, dysuria, and genital ulcers. The prevalences of gonococcal infection, nonspecific urethritis and cervicitis, genital ulcer disease, and trichomoniasis were 27.0%, 18.9%, 16.2%, and 10.8%, respectively, among HIV-infected STD patients; none of the associations between specific STDs and HIV were statistically significant. Only 1 patient had developed clinical signs of acquired immunodeficiency syndrome (AIDS). The 6.4% prevalence rate detected among STD patients in this study was considered high since HIV is new to Nigeria (436 cases reported to date). Overall, these findings suggest that the AIDS epidemic is in an early stage in Nigeria and the major mode of HIV transmission is heterosexual sex. Routine HIV screening for high-risk groups in Nigeria, including STD patients, is recommended.
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PMID:Clinico-epidemiological patterns of HIV infection in STD patients in Ibadan. 888 45

Indinavir sulfate has been reported to cause asymptomatic crystalluria and nephrolithiasis in patients with human immunodeficiency virus (HIV) infection. Patients taking indinavir may present with asymptomatic crystalluria, nephrolithiasis with frank renal colic and obstruction, flank pain in the absence of nephrolithiasis, and dysuria or urgency. Asymptomatic crystalluria has been described as benign. Discontinuation of the drug has not been recommended in the absence of nephrolithiasis. We report two HIV-positive patients receiving indinavir who developed acute interstitial nephritis with foreign body giant cell reaction on renal biopsies. Both patients had asymptomatic crystalluria, although crystals were associated with clumps of white blood cells (WBCs) on urinalysis in one patient. Both cases show that the inflammatory response was significant enough to lead to tubular injury and acute renal impairment. Our findings suggest that asymptomatic crystalluria attributable to indinavir may illicit an inflammatory response with acute renal insufficiency, warranting monitoring of renal function, especially in patients with crystalluria.
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PMID:Acute tubulointerstitial nephritis attributable to indinavir therapy. 1073 9

A 26-year-old male patient with mitral valve prolapse and HLA-B27 antigen received endodontic treatment for dental caries. Two weeks later fever, dysuria, diarrhea, sterile inflammatory arthritis of lower limbs, enthesitis, dactylitis, conjunctivitis, and uveitis consecutively developed. Blood culture performed at the time of active arthritis yielded Streptococcus viridans. He did not have any history of psoriasis, acute infectious diarrhea, chronic inflammatory bowel diseases, or sexually transmitted diseases. Laboratory studies also excluded the possibility of infections by human immunodeficiency virus, hepatitis B or C virus, chlamydia, and streptococci from the upper airway. This report indicates that Streptococcus viridans can be the triggering microorganisms of Reiter's syndrome in some circumstances.
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PMID:Reiter's syndrome caused by Streptococcus viridans in a patient with HLA-B27 antigen. 1089 81

Indinavir is a well-known cause of crystal-induced acute renal failure, dysuria and flank pain, and nephrolithiasis. Recently a more insidious tubulointerstitial lesion has been recognized as secondary to the drug. We report a case of a hepatitis C-positive patient on long-term indinavir therapy for human immunodeficiency virus (HIV) who developed a slowly progressive rise in serum creatinine. Renal biopsy revealed a diffuse interstitial infiltrate with numerous eosinophils and scarring. The tubules showed focal necrosis and dilation with elongated crystals present within their lumina. The elevated serum creatinine decreased to a new baseline over several months with the discontinuation of indinavir. We review the literature of renal syndromes associated with indinavir focusing on chronic progressive tubulointerstitial injury and speculate on risk factors and potential mechanisms of indinavir-induced renal injury.
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PMID:Indinavir nephropathy revisited: a pattern of insidious renal failure with identifiable risk factors. 1157 10

Patients with sexually transmitted diseases (STDs) in developing countries are often untreated for long periods of time or receive ineffective treatment, producing complications that can lead to infertility, blindness, and even death. In addition, there is growing research evidence that people with bacterial or viral STDs are more likely to acquire--and perhaps transmit--the human immunodeficiency virus (HIV). STD control programs in developing countries must be reorganized to include: 1) good management of patients with STDs and their contacts, 2) case finding for syphilis in the antenatal population, 3) screenings and case findings for gonorrhea in high-risk groups, and 4) systematic prophylaxis for ophthalmia neonatorum in newborns. Since diagnosis before treatment is problematic in rural areas, the World Health Organization recommends simple treatment protocols based on the most common STD symptoms--urethral discharge; gynecological complaints such as vaginal discharge, low abdominal pain, or dysuria; genital ulceration; and inguinal bubo, a swelling of the lymph nodes in the groin. Other components of this approach include standardized treatment, contact tracing and treatment, health education targeted at high-risk groups, follow-up and case referral where necessary, and the collection of simple statistics on treatment efficacy and STD epidemiology. The incidence of STDs in developing countries is steadily increasing as a result of urbanization, increased numbers of young people, and delayed age at marriage. However, this situation can be combatted through application of treatment protocols, technological advances, improvements in the health care delivery system, and awareness on the part of policy makers of the seriousness of the STD problem.
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PMID:Management of sexually transmitted diseases. 1234 18

The most common site of Neisseria gonorrhoeae infection is the urogenital tract. Men with this infection may experience dysuria with penile discharge, and women may have mild vaginal mucopurulent discharge, severe pelvic pain, or no symptoms. Other N. gonorrhoeae infections include anorectal, conjunctival, pharyngeal, and ovarian/uterine. Infections that occur in the neonatal period may cause ophthalmia neonatorum. If left untreated, N. gonorrhoeae infections can disseminate to other areas of the body, which commonly causes synovium and skin infections. Disseminated gonococcal infection presents as a few skin lesions that are limited to the extremities. These legions start as papules and progress into bullae, petechiae, and necrotic lesions. The most commonly infected joints include wrists, ankles, and the joints of the hands and feet. Urogenital N. gonorrhoeae infections can be diagnosed using culture or nonculture (e.g., the nucleic acid amplification test) techniques. When multiple sites are potentially infected, culture is the only approved diagnostic test. Treatments for uncomplicated urogenital, anorectal, or pharyngeal gonococcal infections include cephalosporins and fluoroquinolones. Fluoroquinolones should not be used in patients who live in or may have contracted gonorrhea in Asia, the Pacific islands, or California, or in men who have sex with men. Gonorrhea infection should prompt physicians to test for other sexually transmitted diseases, including human immunodeficiency virus.
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PMID:Diagnosis and treatment of Neisseria gonorrhoeae infections. 1673 55

Symptoms of urethritis in men typically include urethral discharge, penile itching or tingling, and dysuria. A diagnosis can be made if at least one of the following is present: discharge, a positive result on a leukocyte esterase test in first-void urine, or at least 10 white blood cells per high-power field in urine sediment. The primary pathogens associated with urethritis are Chlamydia trachomatis and Neisseria gonorrhoeae. Racial disparities in the prevalence of sexually transmitted infections persist in the United States, with rates of gonorrhea 40 times higher in black adolescent males than in white adolescent males. Recent studies have focused on identifying causes of nongonococcal urethritis and developing testing for atypical organisms, such as Mycoplasma genitalium and Ureaplasma species. Less common pathogens identified in patients with urethritis include Trichomonas species, adenovirus, and herpes simplex virus. History and examination findings can help distinguish urethritis from other urogenital syndromes, such as epididymitis, orchitis, and prostatitis. The goals of treatment include alleviating symptoms; preventing complications in the patient and his sexual partners; reducing the transmission of coinfections (particularly human immunodeficiency virus); identifying and treating the patient's contacts; and encouraging behavioral changes that will reduce the risk of recurrence. The combination of azithromycin or doxycycline plus ceftriaxone or cefixime is considered first-line empiric therapy in patients with urethritis. Expedited partner treatment, which involves giving patients prescriptions for partners who have not been examined by the physician, is advocated by the Centers for Disease Control and Prevention and has been approved in many states. There is an association between urethritis and an increased human immunodeficiency virus concentration in semen.
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PMID:Diagnosis and treatment of urethritis in men. 2132 7

Neisseria gonorrhoeae causes urogenital, anorectal, conjunctival, and pharyngeal infections. Urogenital tract infections are most common. Men with gonorrhea may present with penile discharge and dysuria, whereas women may present with mucopurulent discharge or pelvic pain; however, women often are asymptomatic. Neonatal infections include conjunctivitis and scalp abscesses. If left untreated, gonorrhea may cause pelvic inflammatory disease in women, or it may disseminate, causing synovial and skin manifestations. Urogenital N. gonorrhoeae infection can be diagnosed using culture or nucleic acid amplification testing. Urine nucleic acid amplification tests have a sensitivity and specificity comparable to those of cervical and urethral samples. Fluoroquinolones are no longer recommended for the treatment of gonorrhea because of antimicrobial resistance. A single intramuscular injection of ceftriaxone, 250 mg, is first-line treatment for uncomplicated urogenital, anorectal, or pharyngeal gonococcal infections. This dosage is more effective for common pharyngeal infections than the previously recommended dose of 125 mg. Ceftriaxone should routinely be accompanied by azithromycin or doxycycline to address the likelihood of coinfection with Chlamydia trachomatis. Azithromycin may be used as an alternative treatment option for patients with previous allergic reactions to penicillin, but because of the likelihood of antimicrobial resistance, its use should be limited. Gonococcal infection should prompt physicians to test for other sexually transmitted infections, including human immunodeficiency virus. Because of high reinfection rates, patients should be retested in three to six months. The U.S. Preventive Services Task Force recommends screening for gonorrhea in all sexually active women at increased risk of infection. It also recommends intensive behavioral counseling for persons with or at increased risk of contracting sexually transmitted infections. Condom use is an effective strategy to reduce the risk of infection.
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PMID:Diagnosis and management of gonococcal infections. 2315 46

Approximately 200,000,000 people have schistosomiasis (schistosome infection). Among the schistosomes, Schistosoma haematobium is responsible for the most infections, which are present in 110 million people globally, mostly in sub-Saharan Africa. This pathogen causes an astonishing breadth of sequelae: hematuria, anemia, dysuria, stunting, uremia, bladder cancer, urosepsis, and human immunodeficiency virus coinfection. Refined estimates of the impact of schistosomiasis on quality of life suggest that it rivals malaria. Despite S. haematobium's importance, relevant research has lagged. Here, we review advances that will deepen knowledge of S. haematobium. Three sets of breakthroughs will accelerate discoveries in the pathogenesis of urogenital schistosomiasis (UGS): (1) comparative genomics, (2) the development of functional genomic tools, and (3) the use of animal models to explore S. haematobium-host interactions. Comparative genomics for S. haematobium is feasible, given the sequencing of multiple schistosome genomes. Features of the S. haematobium genome that are conserved among platyhelminth species and others that are unique to S. haematobium may provide novel diagnostic and drug targets for UGS. Although there are technical hurdles, the integrated use of these approaches can elucidate host-pathogen interactions during this infection and can inform the development of techniques for investigating schistosomes in their human and snail hosts and the development of therapeutics and vaccines for the control of UGS.
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PMID:New research tools for urogenital schistosomiasis. 2524 Jan 72


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