1/69. 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 = tuberculosis (Clic here for more details about this article) |
2/69. 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) |
3/69. Tuberculous tenosynovitis and carpal tunnel syndrome as a presentation of hiv disease.We describe a patient who presented with carpal tunnel syndrome secondary to tuberculous tenosynovitis and who was subsequently shown to have hiv infection. Recognition of this atypical presentation of tuberculosis is important for early, effective treatment.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
4/69. Second episode of tuberculosis in an hiv-infected child: relapse or reinfection?We report a case of an hiv-infected child with a second episode of tuberculosis 22 months after completing antituberculosis treatment. dna fingerprinting of organisms from both episodes showed an identical strain of mycobacterium tuberculosis. We believe this to be the first case of confirmed relapsed tuberculosis in an hiv-infected child, and suggest that a longer course of antituberculosis treatment be given to such children. inverted question mark 2000 The British Infection Society.- - - - - - - - - - ranking = 9keywords = tuberculosis (Clic here for more details about this article) |
5/69. Cutaneous tuberculosis in three hiv-infected patients.Although tuberculosis is a common disease in patients infected with hiv, cutaneous presentation is not commonly found. The authors report three hiv-infected patients with cutaneous tuberculosis and lung involvement. Patient 1 presented with a nodular skin lesion on the right forearm and the diagnosis was confirmed by histopathology and PCR study. patients 2 and 3 presented with generalized erythematous papules and vesicopustules on the trunk and extremities. culture grew M. tuberculosis in patient 2 and M. tuberculosis DNA was detected in the skin lesion of patient 3 by the PCR method.- - - - - - - - - - ranking = 8keywords = tuberculosis (Clic here for more details about this article) |
6/69. disclosure of hiv status and human rights: the duties and responsibilities of couples, medical professionals, family members and the state.This case history is about a young husband in india who became hiv positive and did not inform his wife. This man was working for a company in the city of Mumbai when he became ill with tuberculosis and was diagnosed with AIDS. This information was not disclosed to his 21-year-old wife, who was living with her parents-in-law in a rural area of South Kerala. He came home to recover and, supported by his parents' wishes, wanted his wife to become pregnant, even though she had asked that they wait until he had recovered. She came to know that her husband had AIDS and the dangers it posed only when she was eight months pregnant and he was seriously ill. Her husband died some three months after the baby was born and she went back to her parents' house, where she and the baby were living at the mercy of others. The contributors to this multi-authored Roundtable discuss the various human rights issues and the duties and responsibilities involved--not only of spouses and partners to each other but also of medical professionals, family members and the state--which arise from such a case.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
7/69. myoclonus secondary to the concurrent use of trazodone and fluoxetine.A 39-y-o male with a history of human immunodeficiency virus infection and depression was admitted for diagnosis and treatment of tuberculosis and pneumocystis carinii pneumonia infections. Prior to admission, he was on 50 mg trazodone every evening for 2 mo for depression. He was admitted with a 2-w history of fever chills and fatigue and on admission had hand tremors which disappeared at rest. Four days post-admission the trazodone dose was increased to 100 mg and 20 mg fluoxetine was initiated. He became increasingly anxious and his hand tremor worsened 3 d after initiation of the regimen. To rule out drug induced tremor, both trazodone and fluoxetine were discontinued and symptoms resolved in 7 d. Clinicians should be aware of the potential for excessive seratonergic activities secondary to trazodone fluoxetine interactions causing a worsening myoclonus adverse event.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
8/69. Mycobacterial spindle cell pseudotumor of the appendix vermiformis in a patient with aids.Mycobacterial pseudotumor (MP) is a rare pathologic presentation of both mycobacterium tuberculosis and non-tuberculous mycobacterial disease, hitherto reported to occur only in immunosuppressed patients with or without human immunodeficiency virus infection. This lesion shares close pathologic resemblance to certain mesenchymal neoplasms, particularly Kaposi's sarcoma (KS), from which it must be properly differentiated due to distinct prognosis and therapy. We report a case of MP obliterating the lumen of the appendix vermiformis in a 34-year-old patient who died of complications of AIDS at our hospital in Rio de Janeiro. A total of 24 cases of MP (including our patient) have been described in the literature. MP has been found especially in lymph nodes, but extranodal lesions have been described in the skin, spleen, lung, bone marrow, brain and, in our patient, the appendix vermiformis. We offer a review of the other 23 published case reports of MP in both hiv-infected and uninfected patients and discuss the pathologic features that differentiate MP from KS.- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
9/69. The role of passive immunization in hiv-positive patients : a case report.An hiv-positive patient presented with pulmonary tuberculosis as her AIDS-defining diagnosis in 1993 and was effectively treated with 12 months of standard antituberculosis medications (isoniazide, rifampin, and pyrazinamide for 2 months). She received zidovudine for 6 weeks at the time of her diagnosis; however, because of patient preference, she has not received subsequent standard hiv medications (7 years). Her CD4 count at the time of diagnosis (1993) was 297/microL. Monthly passive immunotherapy was administered (fresh frozen plasma from hiv-negative blood donors with a significant titer for the anti-vasoactive intestinal peptide [VIP]/NTM antibody) from December 1993 to June 1994. Her CD4 count increased to > 400/microL during the passive immunotherapy and has remained stable for the past 6 years. The rational for the use of anti-VIP/NTM antibodies preparations in hiv, the possible mode of action of anti-VIP/NTM antibodies, the use of Ig preparations, and the role of exercise as a natural source of anti-VIP/NTM antibodies are discussed. This case report supports the potential therapeutic use of anti-VIP antibodies for treatment of hiv disease.- - - - - - - - - - ranking = 2keywords = tuberculosis (Clic here for more details about this article) |
10/69. Does hiv infection accelerate the development of hepatocellular carcinoma? A case report in a young man.Hepatocellular carcinoma (HCC) is an important cancer. It occurs more often in men than women, and occurs mostly in people 50 to 60 years old. HCC has not been previously reported in a young hiv-seropositive patient in thailand. We documented a very rare case of HCC in a 33 year old man. He was diagnosed and treated as salmonella septicemia and tuberculosis. However, additional diagnosis based on pathological study disclosed a moderately differentiated HCC. Immunohistochemical study of the liver tissue was positive for hepatitis b surface antigen (HBsAg).- - - - - - - - - - ranking = 1keywords = tuberculosis (Clic here for more details about this article) |
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