1/8. sarcoidosis-related anterior uveitis in a patient with human immunodeficiency virus.BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior uveitis secondary to sarcoidosis in a patient infected with human immunodeficiency virus (hiv). Other reported causes of uveitis in hiv-infected patients have included hiv, herpes zoster, tuberculosis, syphilis, toxoplasmosis, cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors such as ritonavir and indinavir. uveitis secondary to sarcoidosis in the non-hiv population is classically seen in young, female, African-American patients. There are rare reports, found exclusively in the pulmonary literature, of sarcoidosis in hiv-infected patients. CASE REPORT: A 38-year-old African-American male infected with hiv was treated for chronic recurrent anterior uveitis secondary to sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset of his uveitis. During the previous 6 years he has been treated with anti-hiv antivirals as well as prophylaxis for opportunistic infections. To date, his infectious disease specialist continues to treat his hiv and systemic sarcoidosis. CONCLUSION: patients with hiv infection in whom sarcoidosis with secondary uveitis develops are very rare. Management of these patients requires careful use of topical and oral steroidal anti-inflammatories to control ocular and systemic sequelae of sarcoidosis. This case initiates some interesting questions about the immunology of sarcoidosis and its presence in immunocompromised patients. Use of steroids in an immunocompromised patient is clinically complex. Further clinical study is needed to elicit the full clinical significance of sarcoidosis and hiv infection.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |
2/8. 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 = mycobacterium (Clic here for more details about this article) |
3/8. Atypical mycobacterium infection with sporotrichoid spread in a patient with human immunodeficiency virus.A case of mycobacterium marinum infection presenting with a sporotrichoid spread in a hiv positive Chinese male is presented. The patient responded to oral cotrimoxazole treatment. A brief review of the literature concerning atypical mycobacterial infection presenting in such a fashion is discussed.- - - - - - - - - - ranking = 4keywords = mycobacterium (Clic here for more details about this article) |
4/8. Foreign body granuloma: a new manifestation of immune restoration syndrome.BACKGROUND: People with human immunodeficiency virus may experience an immune restoration syndrome during the lymphocyte recovery period following effective highly active antiretroviral therapy. In this syndrome, antigens that previously were ignored by the immune system now induce an exaggerated response with obvious clinical effects. Most cases have been associated with infectious agents such as cytomegalovirus or mycobacterium avium intracellulare. However, the sudden onset of sarcoidal granulomatous reactions have also been described in this setting. OBJECTIVE: We report a 66-year-old hiv-positive man who presented with exacerbation of multiple foreign body granulomas decades after the original injuries. The presentation coincided with a significant rise in CD4 count after beginning highly active antiretroviral therapy. CONCLUSION: We propose that this case demonstrates another manifestation of the immune restoration syndrome and postulate that an uncontrolled Th1 response is the causative mechanism.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |
5/8. Isolation of a novel sequevar of Mycobacterium flavescens from the synovial fluid of an AIDS patient.This report describes the characterisation of a mycobacterium involved in a case of septic arthritis in an AIDS patient that was treated successfully with specific anti-mycobacterial drugs. The biochemical and cultural features, and the mycolic acid pattern as assessed by high-performance liquid chromatography, were fully compatible with the isolate being Mycobacterium flavescens. However, the isolate's 16S rDNA sequence differed by five nucleotides from the two known sequevars of M. flavescens, thus indicating that this isolate belonged to a new 16S rDNA sequevar.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |
6/8. Mycobacterium conspicuum sp. nov., a new species isolated from patients with disseminated infections.A new type of slowly growing, nonphotochromogenic mycobacterium was recovered from two patients with disseminated disease. The growth characteristics, acid fastness, acids were consistent with those for Mycobacterium species. The results of biochemical investigations, lipid analyses, and comparative 16S rRNA sequencing showed that these isolates represent a new slowly growing Mycobacterium species which is named Mycobacterium conspicuum.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |
7/8. Oral mycobacterium avium complex infection in a patient with hiv-related disease. A case report.mycobacterium avium complex infection is a common complication of the later stages of AIDS. Although a recognized cause of oral lesions, atypical mycobacteria are rarely detected in AIDS-related oral ulceration. Here we report a case of oral ulceration in a patient in the later stages of AIDS in which atypical mycobacteria were detected both histologically and microbiologically. The features of this case are similar to the one other case previously reported permitting some characterization and comparison of the clinical features of mycobacterium avium complex infection in AIDS.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |
8/8. Clinical application of the mycobacterium tuberculosis direct test: case report, literature review, and proposed clinical algorithm.The relatively new mycobacterium tuberculosis direct test (MTDT) enzymatically amplifies M tuberculosis complex 16s ribosomal rna. The sensitivity of the test ranges from 75 to 100%, with specificity of 95 to 100%, positive predictive value between 78% and 100%, and negative predictive value between 95% and 100%. Similar test characteristics have been documented in nonrespiratory specimens and in specimens that ultimately grow nontuberculous mycobacterium (NTM). This test allows for rapid identification of M tuberculosis in the smear-positive patient and may greatly improve sensitivity over acid-fast bacilli smear alone. A negative test result with a positive smear suggests infection with NTM or mycobacterium avium complex. We present a case that illustrates the value of MTDT for analysis of tissue specimens in immunocompromised patients with suspected mycobacterial disease and review the rapidly developing literature about this test. We propose an algorithm using MTDT, acid-fast smear, and mycobacterial culture for the diagnosis and treatment of the immunocompromised patient with suspected mycobacterial infection.- - - - - - - - - - ranking = 1keywords = mycobacterium (Clic here for more details about this article) |