1/7. Successful treatment of idiopathic colitis and proctitis using thalidomide in persons infected with human immunodeficiency virus.Gastrointestinal ulcerations in persons infected with hiv have many causes, the most common being opportunistic infections and neoplasms. Recently, idiopathic ulcerative lesions of the colon and rectum have been described. Two cases are reported of idiopathic colonic and anorectal inflammation and ulceration which failed traditional therapies but responded to thalidomide with complete clinical and histologic resolution.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/7. nocardia asteroides lung abscess in acute ulcerative colitis treated with cyclosporine.cyclosporine is a potent suppresser of cell-mediated immunity that is mainly used in organ transplantation to prevent rejection. It is also being used increasingly outside of transplantation and probably is the only new treatment to have made an impact in acute ulcerative colitis (UC) resistant to steroid therapy. We describe a case of nocardia asteroides lung abscess in a patient treated with cyclosporine for acute steroid resistant UC that was successfully managed with antibiotics and by discontinuing cyclosporine. With increasing use of cyclosporine for acute UC it is to be anticipated that opportunistic infections such as Nocardia will be more frequently encountered in the future.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/7. Intractable diarrhea and melena in an AIDS patient.A young Arab male, clinically suspected to have ulcerative colitis, was operated upon for fulminant intractable diarrhea with melena. The colon showed severe necrotizing and hemorrhagic colitis which was attributed to an opportunistic infection, viz cytomegalovirus infection. The patient's immunocompromised state was a consequence of AIDS, proved by ELISA and Western Blot test. He subsequently developed multiple brain abscesses and succumbed to uncontrolled infection.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/7. A case of systemic strongyloidiasis in an ex-coal miner with idiopathic colitis.An ex-coal miner was diagnosed with an idiopathic sigmoiditis compatible with colitis ulcerosa. He was treated with corticosteroids because of his deteriorating clinical condition, but his condition continued to worsen. He revealed to have a systemic strongyloides stercoralis hyperinfection and Strongyloides colitis. A short time after diagnosis he died from septic shock despite therapy with thiabendazole and antibiotics. S. stercoralis is an opportunistic infection that is not uncommon and has high mortality in hyperinfection. It is prevalent in (sub)tropical areas, and also in coal mines because of the specific microclimate. However, the parasite is difficult to detect because eosinophilia can appear normal in chronic infection. Several stool examinations, duodenal aspiration or biopsies are necessary for a high diagnostic sensitivity. Serological diagnosis is the most sensitive and specific but is not always available.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/7. Extensive ulcerative colitis and extraintestinal manifestations in a patient with hiv infection and significant CD4 T-cell lymphopenia.We report a heterosexual patient with hiv infection and a CD4 T-cell count of 0.45 x 10(9)/L who developed mild ulcerative proctitis, sacroileitis and oligoarthiritis. While he was treated with 5-aminosalicylic enemas, the patient rapidly developed severe pancolitis. An emergency colectomy without procetectomy was performed. A few months later, he suffered recurrence of ulcerative proctitis, aggravation of arthritic pain and developed anterior uveitis. All symptoms disappeared after proctectomy. There was no evidence for opportunistic infection or Kaposi's sarcoma. Antineutrophil cytoplasmic antibodies were positive and the hla-b27 antigen was present. CD4 counts were lower during the phases of active disease than during remission. This case demonstrates that severe ulcerative colitis can occur in the presence of moderate T-cell defects. In view of a recent report of remission of Crohn's disease under comparable circumstances, it is possible that the extent of T-cell involvement in both diseases is radically different.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/7. Drug-induced pneumonitis caused by sulfamethoxazole, trimethoprim during treatment of pneumocystis carinii pneumonia in a patient with refractory ulcerative colitis.We recently treated a patient with intractable ulcerative colitis complicated with pneumocystis carinii pneumonia in whom sulfamethoxazole/trimethoprim caused pneumonitis. The pneumonitis was difficult to differentiate from worsening of the infection or the appearance of another opportunistic infection. The patient's history of sulfasalazine (sulfonamide)-induced pneumonitis made diagnosis possible. The CD4/CD8 ratio of lymphocyte subsets in bronchoalveolar lavage fluid was decreased at the diagnosis of pneumocystis carinii pneumonia and this ratio had increased when drug-induced pneumonitis was diagnosed. Topical administration of beclomethasone dipropionate by enema was a safe and effective for the treatment of such a compromised patient with active colitis.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/7. Severe gastrointestinal hemorrhage due to mycobacterium avium complex in a patient receiving immunosuppressive therapy.Intense immunosuppressive therapy is used frequently for treatment of systemic vasculitides, collagenoses, rapidly progressive glomerulonephritis, and after organ transplantation. Numerous serious treatment-related side effects include localized or disseminated opportunistic infections, and require careful monitoring of immunosuppressed patients. Gastrointestinal infections with mycobacterium avium complex (MAC) or other nontuberculous mycobacteria have been previously identified in hiv seropositive patients only. We now report the first case of an hiv seronegative patient who received immunosuppressive therapy for rapidly progressive glomerulonephritis. The patient presented with severe lower gastrointestinal bleeding and was diagnosed to have ulcerative colitis due to infection with MAC. The patient recovered promptly after administration of antimycobacterial therapy. MAC infection should be included in the differential diagnosis of gastrointestinal bleeding in all immunodeficient patients. The significance of repeated colonoscopy to obtain multiple biopsy specimens with histological examination for foam cells and specific staining for acid-fast organisms is emphasized.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |