1/7. coinfection of cryptosporidium and geotrichum in a case of AIDS.A 32 year old male, positive for human immunodeficiency virus (mY) antibodies, was found to be positive for multiple opportunistic infections by a parasite and a fungi, which is a very rare occurrence. cryptosporidium and geotrichum were simultaneously detected from his stool and sputum respectively.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/7. Management of opportunistic infections complicating the acquired immunodeficiency syndrome.Therapy of opportunistic infection in patients with the acquired immunodeficiency syndrome is frustrating, and there is no convincing evidence that aggressive treatment and/or prophylaxis other than for pneumocystis infection can significantly prolong life. While much clinical effort is expended on treating sequential life-threatening infections, the overall course is usually progressively downhill. Thus, any real impact on the disease should be aimed at the causative viral agent, because it is destruction of a critical component of the immune system that predisposes to opportunistic infections.- - - - - - - - - - ranking = 6keywords = opportunistic infection (Clic here for more details about this article) |
3/7. Overwhelming strongyloidiasis: an unappreciated opportunistic infection.strongyloides stercoralis is an intestinal nematode which infects a large portion of the world's population. Individuals with infection confined to the intestinal tract are often asymptomatic but may have abdominal pain, weight loss, diarrhea, and other nonspecific complaints. Enhanced proliferation of the parasite in compromised hosts causes an augmentation of the normal life-cycle. Resultant massive invasion of the gastrointestinal tract and lungs is termed the hyperinfection syndrome. If the worm burden is excessive, parasitic invasion of other tissues occurs and is termed disseminated strongyloidiasis. A variety of underlying conditions appear to predispose to severe infections. These are primarily diseases characterized by immunodeficiency due to defective T-lymphocyte function (Table 1). Individuals with less severe disorders become compromised hosts because of therapeutic regimens consisting of corticosteroids or other immunosuppressive medication. The debilitation of chronic illness or malnutrition also predisposes to systemic stronglyloidiasis. The diagnosis of strongyloidiasis can be readily made by microscopic examination of concentrates of upper small bowel fluid, stool, or sputum. Important clues suggesting this infection include unexplained gram-negative bacillary bacteremia in a compromised host who may have vague abdominal complaints, an ileus pattern on X-ray, and pulmonary infiltrates. eosinophilia is helpful, if present, but should not be relied upon to exclude the diagnosis. The treatment of systemic infection due to strongyloides stercoralis with either thiabensazole 25 mg/kg orally twice daily is satisfactory if the diagnosis is made early. Because of several unusual features of this illness in compromised hosts, the standard recommendation for 2 days of therapy should be abandoned in such patients. Immunodeficiency, corticosteroids, and bowel ileus reduce drug efficacy. Thus a longer treatment period of at leuch as blind loops or diverticula necessitate longer treatment. Stool specimens and upper small bowel aspirates should be monitored regularly and treatment continued several days beyond the last evidence of the parasite. In particularly difficult situations where either worm eradication is impossible or reinfection is probable, short monthly courses of antihelminthic therapy seem to be effective in averting recurrent systemic illness. Finally, prevention of hyperinfection or dissemination due to strongyloides stercoralis can be accomplished by screening immunocompromised hosts with stool and upper small bowel aspirate examinations. These would be especially important prior to initiating chemotherapy, or before giving immunosuppressive medications or corticosteroids to patients with nonneoplastic conditions such as systemic lupus erythematosus, nephrotic syndrome, or renal allografts.- - - - - - - - - - ranking = 4keywords = opportunistic infection (Clic here for more details about this article) |
4/7. isospora belli in a patient with acquired immunodeficiency syndrome.isospora belli is a cause of protracted diarrhea in immunocompromised patients. acquired immunodeficiency syndrome (AIDS), seen mostly in homosexual men and narcotic addicts, predisposes affected persons to a number of opportunistic infections. As isospora belli has been reported only once in this group, we report isospora belli in an AIDS patient with chronic diarrhea.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/7. Overwhelming watery diarrhea associated with a cryptosporidium in an immunosuppressed patient.A 39-year-old man with severe bullous pemphigoid developed overwhelming diarrhea after 5 weeks' treatment with 150 mg of cyclophosphamide and 60 mg of prednisolone daily. Jejunal and ileal biopsies showed severe mucosal injury and tiny 2- to 4-mu organisms on the epithelial surfaces. Similar organisms were seen in smears of jejunal fluid. Electron microscopic examination of jejunal biopsies showed these spherical bodies to be trophozoites, schizonts, microgametocytes, and macrogametocytes typical of the genus cryptosporidium. diarrhea resolved 2 weeks after discontinuation of cyclophosphamide and coincided with disappearance of Cryptosporidia from the jejunal biopsies. immunosuppression may have predisposed this patient to cryptosporidial diarrhea. cryptosporidiosis is another infection which can be diagnosed by small bowel biopsy. When immunosuppressed patients develop severe diarrhea, opportunistic infection with this and other organisms should be considered as the possible cause.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/7. Intestinal coinfection with enterocytozoon bieneusi and cryptosporidium in a human immunodeficiency virus-infected child with chronic diarrhea.The microsporidian enterocytozoon bieneusi has been recognized as an important cause of chronic diarrhea in severely immunodeficient adults infected with human immunodeficiency virus (hiv). We report the first case of intestinal E. bieneusi infection in a child. The 9-year-old boy with connatal hiv infection presented with failure to thrive, chronic diarrhea, and intermittent abdominal pain. His cd4 lymphocyte count was 0.05 x 10(9)/L and dropped to 0.01 x 10(9)/L. No hiv-associated opportunistic infection other than oral hairy leukoplakia and oral candidiasis had been found before microsporidia were detected. Treatment of microsporidiosis with albendazole was of no benefit. During follow-up, the boy also developed intestinal cryptosporidiosis. Evaluation of chronic diarrhea in severely immunodeficient hiv-infected children should include examination for intestinal microsporidia. We recommend the use of a new coprodiagnostic technique that allows detection of microsporidial spores in stool specimens. Furthermore, consideration of dual or even multiple parasitic infections in the differential diagnosis of chronic diarrhea may have both important clinical and epidemiological implications.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/7. Intestinal strongyloidiasis--a rare opportunistic infection.We describe the features of intestinal strongyloidiasis in six patients; five of them were immunosuppressed (four on corticosteroids, one with chronic renal failure). vomiting and diarrhea were the predominant symptoms. Duodenal mucosa on endoscopy varied from normal to severe ulceration. albendazole 400 mg/day for two weeks was effective. This condition should be considered in immunosuppressed individuals with gastrointestinal symptoms, especially since these symptoms may be mistakenly attributed to the underlying disease.- - - - - - - - - - ranking = 4keywords = opportunistic infection (Clic here for more details about this article) |