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)

A family including three children with DiGeorge syndrome is described. One child died in the neonatal period from cardiac anomalies accompanying complete DiGeorge syndrome. The two surviving siblings shared a common set of pharyngeal pouch anomalies and immunodeficiency consistent with partial DiGeorge syndrome, and other morphologic anomalies characteristic of the velocardiofacial syndrome with which familial DiGeorge syndrome is associated (reviewed in reference 1). Both had normal karyotypes. Both presented with recurrent otitis media and sinopulmonary infections, CD4+ T cell lymphopenia, and defective DCH skin test responses to recall T cell antigens. Both had low serum IgM levels and IgG4 levels at the lower limits of normal. Immunization with bacterial polysaccharides resulted in impaired IgG antibody responses to the same set of antigens (H. influenzae polyribophosphate and S. pneumoniae capsular serotypes 9N and 14), while responses to protein antigens were intact. Both siblings were treated successfully with intravenous gamma globulin. The pattern of selective antibody deficiency in these patients with familial DiGeorge syndrome suggests a heritable lesion in certain regulatory antipolysaccharide CD4+ T cell subpopulations.
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PMID:Selective polysaccharide antibody deficiency in familial DiGeorge syndrome. 152 80

Pretreatment sinus puncture was performed on 339 patients with acute community-acquired sinusitis (ACAS) between 1975 and 1990. Bacterial species recovered in titers of greater than or equal to 10(4) colony-forming units per milliliter (CFU/ml) from 383 sinus aspirates included Streptococcus pneumoniae, 92 (41%); Haemophilus influenzae, 79 (35%); anaerobes, 17 (7%); streptococcal species, 16 (7%); Moraxella catarrhalis, 8 (4%); Staphylococcus aureus, 7 (33%); and other, 8 (4%). Viruses (rhinovirus, parainfluenza virus, and influenza virus) and fungi (Aspergillus, zygomycoses, Phaeohyphomycis, Pseudallescheria, and Hyalohyphomycis) have also been reported to cause ACAS. Posttreatment sinus puncture was performed on 220 of the 339 patients in six studies to evaluate efficacy of selected antimicrobial agents in producing bacteriologic cure. Ampicillin, 500 mg four times daily; amoxicillin, 500 mg three times daily; trimethoprim-sulfamethoxazole, twice a day; cefaclor, 500 mg four times daily; bacampicillin, 800 mg twice a day; cyclacillin, 500 mg three times a day; cefuroxime axetil, 250 mg twice daily; amoxicillin-clavulanate, 500/125 three times daily; and loracarbef 400 mg twice daily, given in 10-day courses, produced bacteriologic cure in more than 90% of patients. Early studies were done before beta-lactamase-producing strains of H. influenzae were a frequent cause of ACAS in Charlottesville. Management of therapeutic failures is a difficult problem for which diagnostic and therapeutic sinus puncture and lavage, prolonged antimicrobial therapy, steroid therapy, and evaluation of allergy, immunodeficiency, and surgically correctable lesions of the osteomeatal complex are recommended.
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PMID:The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. 152 37

Non-capsulated Haemophilus influenzae may cause neonatal septicaemia. Genital carriage of this pathogen was studied in 3 mothers of infected neonates and in 2 pregnant women in the first trimester. A carrier state in 2 of the females was terminated by antibiotic therapy after 3 and 7 months, respectively. A previous carrier had no recurrence of H. influenzae in a subsequent pregnancy. A survey of 544 parturient women revealed a carrier rate of 1.8/1,000 (95% confidence limits: 0.1-11). Carriage of non-capsulated H. influenzae is thus rare, and pregnant women may be successfully treated in order to reduce the risk of neonatal infection. There was no evidence of immunodeficiency in women with non-capsulated H. influenzae in the genital tract.
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PMID:Non-capsulated Haemophilus influenzae in the genital flora of pregnant and post-puerperal women. 185 66

Haemophilus influenzae is a major bacterial pathogen in patients infected with the human immunodeficiency virus (HIV), although most infections with this organism occur in the respiratory tract. We describe an adult with HIV infection who presented with epididymo-orchitis due to H. influenzae. Eleven prior cases of H. influenzae epididymo-orchitis have been published, but all of these cases occurred in pediatric patients. Little is known about the prevalence of genitourinary tract infections caused by H. influenzae among adults. H. influenzae is a relatively rare cause of bacteremia in adults, but the frequency of H. influenzae bacteremia has been increasing among the HIV-positive population.
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PMID:Haemophilus influenzae epididymo-orchitis and bacteremia in a man infected with the human immunodeficiency virus. 780 47

We collected clinical and microbiological observations, as well as follow-up on human immunodeficiency virus (HIV)-infected patients with bacterial pneumonia, and compared pneumococcal pneumonia in patients with and without HIV infection. Fifty five HIV-infected patients, who had had 68 episodes of bacterial pneumonia, were studied prospectively. Twenty one HIV-infected patients with pneumococcal pneumonia were compared to 69 non-HIV-infected patients with pneumococcal pneumonia. Aetiological diagnosis was established in 48 cases (71%). The most common causative agents were S. pneumoniae and H. influenzae. Sixty percent of episodes took place in asymptomatic carriers of HIV infection and 37% in acquired immune deficiency syndrome (AIDS) patients. Overall mortality was 10%. Fifty five percent of patients with follow-up had recurrent episodes. Bacteraemic pneumococcal pneumonia was more frequent in HIV- than in non-HIV-infected patients, and the mortality of pneumococcal pneumonia was also higher in HIV- (19%) than in non-HIV-infected (4.3%) patients. We conclude that bacterial pneumonia is a frequent problem in HIV-infected patients and that recurrent episodes are common. The clinical presentation of pneumococcal pneumonia is generally indistinguishable from that occurring in normal hosts, but bacteraemia is more common and the mortality is higher in HIV-infected patients.
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PMID:Bacterial pneumonia in HIV-infected patients: a prospective study of 68 episodes. 816 75

Bacterial respiratory tract infections occur frequently in persons infected with human immunodeficiency virus (HIV) and may be caused by a wide variety of pathogens. Pneumonia is the most commonly diagnosed respiratory infection in HIV-infected persons and is more common in those persons than in non-HIV-infected ones. HIV-infected persons have a much higher risk of pneumococcal disease than do noninfected controls, and disease may occur relatively early in the course of HIV infection. While mortality associated with the disease does not seem to be high among HIV-infected persons, there is a higher rate of recurrence of the disease in that population. Risk factors for pneumococcal disease in HIV-infected persons are not well characterized. Though efficacy data are limited, the 23-valent polysaccharide pneumococcal vaccine is recommended for use early in the course of HIV infection. There are no data suggesting that HIV-infected persons should be revaccinated routinely. Antiretroviral agents may enhance the immunologic response to the polysaccharide vaccine. Prophylactic antibiotics may have a role in preventing recurrences of severe bacterial respiratory infections, and intravenous immunoglobulin may be useful in preventing serious bacterial infections in HIV-infected children. HIV-infected persons are also at greater risk for serious infections with Haemophilus influenzae than are non-HIV-infected persons. Vaccination against H. influenzae type b (Hib) is recommended for HIV-infected children but not for adults. Antimicrobial drug-resistant strains of Streptococcus pneumoniae and H. influenzae have become more prevalent recently and consequently have impacted on strategies for prevention and treatment of those infections.
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PMID:Preventing bacterial respiratory tract infections among persons infected with human immunodeficiency virus. 854 17

3 splenectomized patients infected by the human immunodeficiency virus (HIV) are described. They all presented with more than 500 CD4/mm3 but, surprisingly, with a CD4 percentage below 15, positive p24 antigenemia and a CD4/CD8 ratio below 0.24. 2 patients had repeated episodes of oropharyngeal candidiasis while their CD4 counts exceeded 800/mm3. These episodes suggested the presence of a certain degree of immuno-suppression and prompted us to introduce anti-HIV therapy. 2 patients also presented with a pulmonary infection, due to Klebsiella pneumoniae and Haemophilus influenzae respectively. The third patient had septicemia due to Streptococcus pneumoniae type 22, despite vaccination and a CD4 count above 700/mm3. In splenectomized HIV-infected patients the number of CD4 lymphocytes should be interpreted with caution, as this number increases after splenectomy. The CD4 percentage and CD4/CD8 ratio correlated better with the clinical stage of HIV infection and gave more valuable indications as to the degree of immunosuppression. A possible correlation between viremia and the number of CD4 lymphocytes in this subset of patients remains to be established. In HIV-infected patients, infections due to S. pneumoniae, H. influenzae, S. aureus and enteric gram-negative bacteria are frequent. After splenectomy, susceptibility to encapsulated bacteria increases even in HIV-negative patients. Early vaccination against the main strains of S. pneumoniae is essential, as vaccinal response is uncertain in patients with less than 400 CD4/mm3.
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PMID:[HIV infection and splenectomy: 3 cases and literature review]. 892 55

Patients with aids are at increased risk of opportunistic and non opportunistic infections. It is now known that the incidence can be reduced by prophylactic measures and/or the use of vaccines. HIV infection produces an elevated frequency of severe pneumococcal disease with a rate of bacteriemia caused by Streptococcus pneumoniae 150-300 fold greater than rates reported in non-HIV infected people. For this reason, pneumococcal vaccine should be administered as early as possible in the course of the infection. Besides, the antibody response may be significantly higher for asymptomatic persons. Acute hepatitis caused by hepatitis B virus is milder than in non HIV infected patients but chronic disease is more frequent. The prognosis is worse and there is higher risk for infecting another persons. Hepatitis B vaccine is indicated for all the patients with HIV and negative serology for hepatitis B virus. Influenza vaccine is of limited effectiveness due to the high variability of the virus. Besides, influenza incidence is low among approximately young adults, HIV related immunodeficiency increased influenza risk only minimally, the vaccine is administered yearly and HIV-replication can increase in temporal association with vaccination. For all these reasons, fewer hospitalizations and deaths are prevented making it a far less cost-effective prevention strategy than pneumococcal vaccination. The risk of Haemophilus influenzae infections is elevated, but the vaccine is not routinely recommended because the more frequent serotype in HIV infected patients is b. For these subjects, passive immunization with immunoglobulin may also be necessary to provide protection. In conclusion, pneumococcal and hepatitis B vaccination is a reasonable prevention strategy for HIV infected patients at all stages of immunodeficiency. Influenza and H. influenzae vaccination are not recommended and alternative prevention strategies may be done.
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PMID:[Which are the vaccines that human immunodeficiency virus infected patients must receive?]. 978 Apr 28

Although Haemophilus influenzae is a common etiologic agent of pneumonia in patients infected with human immunodeficiency virus (HIV), the characteristics of this pneumonia have not been adequately assessed. We have prospectively studied features of H. influenzae pneumonia in 26 consecutive HIV-infected inpatients. Most of these patients were severely immunosuppressed; 73.1% had a CD4+ cell count <100/microL. A subacute clinical presentation was observed in 27% of the patients and was associated with a higher degree of immunosuppression (P=.04). Bilateral lung infiltrates were noted radiographically in 57.7% of the cases. The mortality attributable to H. influenzae pneumonia was 11.5%. Thus, pneumonia caused by H. influenzae affects mainly patients with advanced HIV disease, and since its clinical and radiological features may be diverse, this etiology should be considered when pneumonia occurs in patients with advanced HIV infection. The mortality rate associated with H. influenzae pneumonia is not higher than that occurring in the general population.
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PMID:Haemophilus influenzae pneumonia in human immunodeficiency virus-infected patients. The Grupo Andaluz para el Estudio de las Enfermedades Infecciosas. 1072 28

A 32-year-old male was admitted to our hospital complaining of fever and dyspnea on effort. Laboratory data on admission indicated leukocytosis and elevation of C-reactive protein. A chest radiograph showed diffuse reticulonodular shadows in both lower lung fields, and a chest computed tomography showed centrilobular reticulonodular opacity. Bronchoscopic findings revealed a large amount of slightly yellowish secretion in all bronchi. Cells found in the bronchoalveolar lavage fluid (BALF) included 61% neutrophils. Haemophilus influenzae was isolated from cultures of the BALF and sputum. Transtracheal lung biopsy specimens showed focal infiltration of neutrophils in the alveoli, and the pathological findings in the lung were compatible with bronchiolopneumonia. Since the CD4/CD8 ratio was 0.09 and a positive reaction was obtained for anti-human immunodeficiency virus (HIV) antibody, HIV-associated pneumonia due to H. influenzae was diagnosed. Seven days' administration of cefozopran improved the patient's condition. It is interesting that radiological findings are often unusual in HIV-infected patients with H. influenzae pneumonia.
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PMID:[A case of AIDS-associated Haemophilus influenzae pneumonia with diffuse reticulonodular shadows]. 1264 13


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