1/4. typhoid fever and hiv infection: a rare disease association in industrialized countries.typhoid fever is still a global health problem, mainly in tropical and subtropical areas of the world and in developing countries, where relatively elevated morbidity and mortality rates still are present, mostly because of persisting poor hygienic conditions. In the majority of Mediterranean regions, including italy, the disease is constantly present, though with a low prevalence rate, as a result of an endemic persistence of salmonella typhi infection.1-4 On the other hand, in industrialized countries, most cases of S. typhi infection are related to foreign travel or prior residence in endemic countries.4-6 In the united states, 2445 cases of typhoid fever have been reported in the decade 1985 to 1994, and the annual number of cases remained relatively stable over time: over 70% of episodes were acquired in endemic countries (mostly mexico and india).6 The persisting morbidity of S. typhi also may be supported by the increasing resistance rate of this pathogen against a number of commonly used antimicrobial compounds. For instance, 6% of 331 evaluable S. typhi strains were resistant to ampicillin, chloramphenicol, and cotrimoxazole, and 22% of isolates were resistant to at least one of these three agents in a recent survey performed in the united states.6 The spread of antibiotic resistance among S. typhi isolates is emerging in many countries, and multidrug-resistant strains have been isolated, as well as isolates with poor susceptibility to fluoroquinolones,3-5,7-9 so that in vitro susceptibility should be determined for all cultured strains, and antimicrobial treatment should be adjusted accordingly. Nevertheless, fluoroquinolones (e.g., ciprofloxacin and pefloxacin) or third-generation cephalosporins, still represent the best choice for empirical treatment,2,4,6-8,10 and mortality remains rare in Western countries (less than 1% of episodes), although it is expected to be greater in developing areas of the world. The aim of this report is to describe two cases of typhoid fever that occurred in patients with human immunodeficiency virus (hiv) infection, a rarely reported disease association in industrialized countries.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
2/4. erythema elevatum diutinum in a patient with human immunodeficiency virus.erythema elevatum diutinum (EED) is a chronic cutaneous leukocytoclastic vasculitis. This rare disease is characterized by red, brownish-purple, and yellow papules, plaques, and nodules distributed symmetrically about the extremities. There have been recent reports of the disease in association with infection with the human immunodeficiency virus (hiv). We describe the case of a 51-year-old man with hiv who presented with EED, which was successfully treated with dapsone.- - - - - - - - - - ranking = 0.25keywords = rare disease (Clic here for more details about this article) |
3/4. Autoimmune hepatitis in an hiv infected patient that responded to antiretroviral therapy.Autoimmune hepatitis is a rare disease with unclear pathogenesis. Several viruses have been proposed to act as triggering agents for the inflammatory process of the disease; however, hiv has only very rarely been reported to be associated. We report a case of a patient with autoimmune hepatitis and hiv infection. The possible pathogenetic mechanism is discussed. Antiretroviral treatment led to normalization of liver biochemistry, supporting the hypothesis of hiv induced autoimmune hepatitis.- - - - - - - - - - ranking = 0.25keywords = rare disease (Clic here for more details about this article) |
4/4. Bladder carcinoma and hiv infection during the highly active antiretroviral therapy era: A rare, but intriguing association. Two case reports and literature review.Two very rare case reports of bladder transitional cell carcinoma associated with hiv infection in patients treated with combined antiretroviral therapy are described, and discussed on the ground of the most relevant and updated literature resources. Only 13 cases of vesical carcinoma have been reported to date in the setting of hiv infection, but only 3 anecdotal single reports (the last in the y 2001) described clinical, therapeutic, and outcome issues of this rare disease association in some detail. In our patients, micro- or macro-haematuria was the clue for in-depth diagnosis and prompt treatment, which was limited to multiple local interventions in 1 case, but finally required a radical cystectomy in the second patient. No relationship was found with the very favourable underlying hiv-related virological and immunological status, and the present 8-12-month follow-up did not show disease relapses.- - - - - - - - - - ranking = 0.25keywords = rare disease (Clic here for more details about this article) |