1/148. Identification of Mycobacterium shimoidei by molecular techniques: case report and summary of the literature.A 53-year-old woman from Melbourne, australia, with squamous cell carcinoma of the oesophagus was shown by computed tomography (CT) scan to have a left apical cavity and inflammatory changes in the right lung consistent with aspiration. Acid-fast bacilli isolated from bronchial washings were identified biochemically first as Mycobacterium terrae, but later as M. shimoidei on the basis of 1) restriction fragment analysis and 2) sequencing of polymerase chain reaction (PCR) amplified 16S rDNA. Nine other descriptions of patients with M. shimoidei isolates were collated. The salient feature of isolates considered to be pathogenic was pulmonary cavitation. Most patients had underlying lung disease, including past tuberculosis or malignancy. Six of eight patients died of progressive respiratory illness, although the contribution of M. shimoidei was not always clear, and two patients improved. One patient with the acquired immune-deficiency syndrome (AIDS) died with salmonella enteritidis and M. shimoidei isolated from blood cultures. One isolate was regarded as a coloniser. There are insufficient clinical or sensitivity data on which to base recommendations for therapy, but a combination of ethambutol, rifabutin and pyrazinamide could be considered.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
2/148. Paralytic poliomyelitis associated with live oral poliomyelitis vaccine in child with HIV infection in zimbabwe: case report.OBJECTIVE: To describe a complication of oral vaccination with live, attenuated poliomyelitis virus in a child infected with HIV. DESIGN: Case report. SETTING: teaching hospital in Harare, zimbabwe. SUBJECTS: A boy of 41/2 years and his mother. MAIN OUTCOME MEASURES: Results of clinical and laboratory investigations. RESULTS: Two weeks after receiving the second dose of oral poliomyelitis vaccine during national immunisation days the child developed paralysis of the right leg. He had a high titre of antibodies against poliovirus type 2, as well as antibodies against hiv-1, a low CD4 count, a ratio of CD4 to CD8 count of 0.47, and hypergammaglobulinaemia. He did not have any antibodies against diphtheria, tetanus, or poliovirus types 1 and 3, although he had been given diphtheria, tetanus, and pertussis and oral polio vaccines during his first year and a booster of the diphtheria, tetanus, and pertussis vaccine at 24 months. He had no clinical symptoms of AIDS, but his mother had AIDS and tuberculosis. CONCLUSION: Paralytic poliomyelitis in this child with HIV infection was caused by poliovirus type 2 after oral poliomyelitis vaccine.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
3/148. Multiple tubercular ulcer perforation of ileum in an AIDS patient: case report.intestinal perforation is an extremely uncommon complication of mycobacterium tuberculosis (MTB) infection. We report a case of HIV infection in a male injecting drug user (IDU) with intestinal tuberculosis complicated with multiple ileal perforations at the Regional Institute of Medical Sciences Hospital, Imphal, Manipur. The emergency surgical therapy supported by antitubercular drugs (ATT) and parenteral nutrition saved the life of this patient who presented in a critical state of shock. The patient manifested with extrapulmonary tuberculosis, which is one of the criteria of AIDS. The authors stress the possibility that in future, tubercular complication till now considered atypical, may become more frequent.- - - - - - - - - - ranking = 3keywords = tuberculosis (Clic here for more details about this article) |
4/148. Unusual pulmonary manifestations of disseminated penicillium marneffei infection in three AIDS patients.penicillium marneffei is a rare fungal pathogen which can cause human infections in people predominantly living in South-east asia and the southern portion of china. We report three cases of systemic P. marneffei infection in patients infected with HIV who lived in or had travelled to endemic areas. The clinical manifestation includes high fever, chills, weight loss, general malaise, chronic cough, haemoptysis, multiple skin lesions, abnormal liver function, etc. Chest X-ray showed single or multiple cavitary lesions with smooth or irregular thin wall. P. marneffei is cultured from blood, sputum, skin biopsy, sono-guide aspiration and bronchoscopic biopsy. After antifungal therapy with intravenous amphotericin b or oral fluconazole, skin lesions resolved completely within 2 weeks and cavitary lesions in the lungs changed to chronic fibrotic and interstitial processes after several months to a few years later. Our two cases had been treated as either pulmonary tuberculosis or suspected malignancy. A definite diagnosis and early treatment are important because this fungal infection is a marker of AIDS in South-east asia.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
5/148. Successful treatment of spleen tuberculosis in a patient with human immunodeficiency virus infection.Tuberculosis in human immunodeficiency virus (HIV)-infected patients may act as a cofactor that accelerates the clinical course of HIV infection, and, indeed, HIV-infected patients with tuberculosis have a reduced survival rate compared to those without tuberculosis. diagnosis of tuberculosis in HIV-positive patients can be difficult because of nonspecific symptoms and the time required for the identification of mycobacteria by means of culture techniques. Recently, antiretroviral combination therapies have improved the outcome of several acquired immune deficiency syndrome (AIDS)-associated conditions. Unfortunately, the use of antiretroviral therapy for patients coinfected with HIV and mycobacterium tuberculosis is still to be fully evaluated. The complexity of side-effects due to antituberculosis medication and drug interaction represent important issues and combining an effective anti-HIV treatment with antituberculosis therapy is still a clinical challenge. We discuss here a case of spleen tuberculosis in a human immunodeficiency virus-positive patient who had a successful response after a diagnostic splenectomy and medical treatment that included classical antituberculosis treatment associated with antiretroviral therapy without protease inhibitors.- - - - - - - - - - ranking = 12keywords = tuberculosis (Clic here for more details about this article) |
6/148. central nervous system toxoplasmosis in acquired immunodeficiency syndrome: An emerging disease in india.With the incidence of patients infected with human immuno-deficiency virus (HIV) increasing in india, the central nervous system (CNS) manifestations of the disease will be seen more frequently. The CNS may be primarily afflicted by the virus or by opportunistic infections and neoplasms secondary to the immune suppression caused by the virus. In india, although mycobacterium tuberculosis has been reported to be the most common opportunistic infection, toxoplasmosis may become as common owing to the ubiquitous nature of the protozoan. Since an empirical trial of medical therapy without histopathological diagnosis is recommended, the true incidence of this condition may remain under estimated. The role of ancillary tests such as radiology and serology in the initial diagnosis of this condition remain crucial. This report highlights two patients who were diagnosed to have acquired immuno-deficiency syndrome (AIDS) only after the biopsy of the intracranial lesion was reported as toxoplasmosis. Presently all patients for elective neurosurgery are tested for HIV antigen. The management protocol to be followed in a known patient with AIDS presenting with CNS symptoms is discussed in detail. The value of ancillary tests is also reviewed.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
7/148. Immune mediated 'HAART' attack during treatment for tuberculosis. Highly active antiretroviral therapy.Highly active antiretroviral therapy (HAART) suppresses viral replication and improves immune function. However the inflammatory component of immune restoration can have clinically deleterious effects on previously asymptomatic infections. We report the development of acute respiratory failure in a patient after the institution of HAART, following 2 months of appropriate therapy for pulmonary tuberculosis. Necrotizing granulomas with acid-fast bacilli were found on lung biopsy, but cultures were negative for mycobacterium tuberculosis and no other pathogens were isolated. polymerase chain reaction of lung biopsy tissue for all mycobacterial species was positive only for M. tuberculosis. Rapid clinical improvement followed corticosteroid therapy. After initiating HAART, clinicians should be aware of the possibility of an inflammatory response to a previously quiescent tuberculous infection, even while on antituberculosis therapy.- - - - - - - - - - ranking = 8keywords = tuberculosis (Clic here for more details about this article) |
8/148. Tuberculous pancreatic abscess in HIV-positive patients. A report of 3 cases and a review of the literature.Three cases of tuberculous pancreatic abscess (TPA) in HIV-positive patients are reported. Pancreatic tuberculosis (PTB) is a rare pathological entity with nonspecific symptomatology that presents a diagnostic challenge. Ultrasound or computed tomography-guided fine-needle aspiration biopsy (FNAB) is recommended, as this may be diagnostic and negate the need for operative intervention.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
9/148. Visceral leishmaniasis masquerading as tuberculosis in a patient with AIDS.We report a case of visceral leishmaniasis presenting as significant lymphadenopathy in a patient with acquired immune deficiency syndrome. The lymphadenopathy was initially suspected to be tubercular in nature on pathological examination. This report highlights the increasing incidence of acquired immune deficiency syndrome and Leishmania co-infection in india, and the importance of demonstrating tubercle bacilli on culture before suggesting a diagnosis of tuberculosis.- - - - - - - - - - ranking = 5keywords = tuberculosis (Clic here for more details about this article) |
10/148. Hypercalcaemia: a clue to mycobacterium avium intracellulare infection in a patient with AIDS.Hypercalcaemia is uncommon in HIV-infected patients and should suggest a different priority for differential diagnosis than would be considered in other settings. Although hypercalcaemia has long been associated with granulomatous diseases including tuberculosis, it has only recently been recognised that patients with illness due to mycobacterium avium intracellulare (MAI) may develop it. We report a patient with AIDS in whom unexplained hypercalcaemia was the harbinger of clinically significant MAI infection. patients with AIDS who develop hypercalcaemia should be closely evaluated for underlying MAI infection.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
| | Next -> |