1/17. When typical is atypical: mycobacterial infection mimicking cutaneous vasculitis.patients with systemic lupus erythematosus (SLE) who present with skin disease pose the clinician with diagnostic challenges. The skin disease can reflect an increase in systemic disease activity suggested by other features of active lupus and, as such, usually responds well to more aggressive immunosuppressive therapy. Other possibilities of skin disease include drug eruptions, skin disease unrelated to SLE and, more rarely, opportunistic skin infection. In patients who show a poor response to more aggressive immunosuppressive therapy, consideration must be given to the possibility of opportunistic infection. A high index of suspicion will allow prompt treatment. We describe two patients with SLE who developed cutaneous atypical mycobacterial infection during immunosuppressive therapy. The diagnosis of cutaneous vasculitis was considered in both cases, but subsequent skin biopsy revealed the correct diagnosis. This report illustrates the importance of skin biopsy in patients with suspected cutaneous lupus who are not responding to immunosuppressive therapy.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/17. A young female patient with anorexia nervosa complicated by Mycobacterium szulgai pulmonary infection.OBJECTIVE: Pulmonary infection with a rare atypical mycobacterium, Mycobacterium szulgai, was discovered during the treatment of anorexia nervosa in a 21-year-old Japanese woman without preexisting pulmonary disease. She had a long history of low body weight below 35 kg. methods: On admission, she was examined. She weighed 23 kg and presented with hypoproteinemia, decreased levels of rapid turnover proteins, liver dysfunction, and decreased serum level of insulin-like growth factor-I. RESULTS: Although she had had neither clinical symptom specific for mycobacterium pulmonary infection nor inflammatory data, a chest roentgenogram showed an infiltrative shadow with cavity formation in the right upper lung field. Isolated bacteria from sputum was acid-fast bacilli and identified as M. szulgai using the dna-dna hybridization method. DISCUSSION: In anorexia nervosa patients with a long history of severe malnutrition, special attention must be paid to the possibility of opportunistic infections, even in the absence of symptoms or inflammatory data.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/17. Mycobacterium simiae: a previously undescribed pathogen in peritoneal dialysis peritonitis.peritonitis is a major complication of peritoneal dialysis (PD). coagulase-negative staphylococcus, staphylococcus aureus , and gram-negative bacteria cause the majority of these infections and usually are amenable to conventional antibiotic therapy, allowing continuation of PD. Mycobacterial and fungal peritonitis represent a more difficult clinical challenge. The infecting organism is often difficult to isolate and can rarely be eradicated without catheter removal. Immunocompromised patients are susceptible to opportunistic infection and, in the context of PD, may have PD peritonitis with different organisms from immunocompetent patients. Here the authors report for the first time PD peritonitis caused by Mycobacterium simiae , a nontuberculous mycobacterium, in a human immunodeficiency virus-positive patient. In addition the difficulty in diagnosing and managing nontuberculous PD peritonitis is discussed.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/17. Mycobacterium intermedium granulomatous dermatitis from hot tub exposure.nontuberculous mycobacteria, which are widespread in the environment, frequently cause opportunistic infections in immunocompromised patients. We report the first case of a patient with chronic granulomatous dermatitis caused by a rarely described organism, Mycobacterium intermedium. The infection was associated with exposure in a home hot tub.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/17. Pancreatic abscess due to mycobacterial infection associated with the acquired immunodeficiency syndrome.Two patients with a history of intravenous drug abuse developed a pancreatic abscess due to mycobacterial infection as their initial evident opportunistic infection in association with the acquired immunodeficiency syndrome (AIDS). This presentation of mycobacterial infection has been previously reported in nine patients. The two patients reported here are the second and third reported cases in association with AIDS. As this entity should be considered a cause of a pancreatic lesion in immunosuppressed patients, fluid drained from a pancreatic abscess should have histologic stains and cultures for mycobacteria.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/17. mycobacterium tuberculosis pneumonia in two hiv antibody positive patients.The acquired immunodeficiency syndrome is associated with the development of opportunistic infections. We report the cases of two hiv antibody positive male partners who developed pneumonia responding to antituberculous therapy.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/17. 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) |
8/17. histoplasmosis in the acquired immune deficiency syndrome.This report describes the experience with disseminated histoplasmosis in seven of 15 patients with the acquired immune deficiency syndrome (AIDS) diagnosed in Indianapolis since 1981. Three were homosexual, two were intravenous drug addicts, one was the spouse of another patient with AIDS and disseminated histoplasmosis, and the seventh was a hemophiliac. Six had associated infections: candidiasis in three, pneumocystis carinii pneumonia, recurrent mucocutaneous herpes simplex infection, and disseminated mycobacterium avium infection in two each, and disseminated infection with an unidentified mycobacterium in one. Clinical diseases suggested sepsis in four. histoplasma fungemia occurred in five, but the diagnosis was established first by visualization of organisms in blood or bone marrow in three. Results of histoplasma serologic tests were positive in each. Three died before receiving 50 mg of amphotericin b, three had prompt improvement with amphotericin b, and one was treated with ketoconazole to prevent dissemination. However, two of the three patients treated with amphotericin b had relapses after a 35 mg/kg course, and the third died within a month following therapy. Disseminated histoplasmosis is a major opportunistic infection in patients with AIDS from endemic areas. AIDS should be strongly considered in otherwise healthy persons with disseminated histoplasmosis, especially if risk factors for AIDS are present. amphotericin b is not curative in these patients.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
9/17. Chest infection due to M. fortuitum in a case of lepromatous leprosy--a case report.Lepromatous leprosy cases may be immunocompromised due to the extensive disease and also because of steroid therapy for repeated reactions. Such patients are likely to be at higher risk for getting opportunistic infection due to various environmental microbes. This paper reports a case of lepromatous leprosy with repeated lepra reaction who was found to have chest infection due to M. fortuitum. It is suggested that mycobacterial culture and sensitivity should be recommended in cases who are immunocompromised and whose pathological specimens contain acid fast bacilli. Species identification and sensitivity can be very helpful in proper management of such cases who will otherwise pass off as tuberculosis.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
10/17. Unusual mycobacteria in 5 cases of opportunistic infections.Five cases of infection due to an unusual mycobacterium are recorded, and the growth requirements and histological findings are discussed. On initial culture, these mycobacteria could be grown only on Lowenstein-Jensen medium containing ferric ammonium citrate, and the histology of the skin lesions was not always typical of mycobacterial disease.- - - - - - - - - - ranking = 4keywords = opportunistic infection (Clic here for more details about this article) |
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