1/139. Pseudogaucher cells in cutaneous Mycobacterium avium intracellulare infection: report of a case.We report on a patient infected with human immunodeficiency virus, and with cutaneous Mycobacterium avium intracellulare, in whom many cells with abundant reticulated cytoplasm resembling the characteristic cells of Gauchers disease ("pseudogaucher cells") were noted within the dermal infiltrate on biopsy. Although pseudogaucher cells have been reported in association with M. avium intracellulare infection in extracutaneous sites, this is, to our knowledge, the first report of cutaneous pseudogaucher cells in the skin.- - - - - - - - - - ranking = 1keywords = intracellulare infection, intracellulare (Clic here for more details about this article) |
2/139. Immunopathology as a result of highly active antiretroviral therapy in hiv-1-infected patients.OBJECTIVE: Unusual clinical inflammatory syndromes associated with underlying previously unrecognized opportunistic infections are increasingly being noted shortly after starting highly active antiretroviral therapy (HAART). This study examined the possible relationship between such unexpected disease manifestations and in vitro parameters of microbial antigen-specific immune reactivity in patients infected with hiv-1 who had a Mycobacterium avium intracellulare or mycobacterium xenopi infection. DESIGN: in vitro T-cell proliferation experiments were performed after specific stimulation of a patient's peripheral blood mononuclear cells (PBMC) with M. avium and M. xenopi antigen and non-specific stimulation with phytohaemagglutinin (PHA). The results were compared with appropriate controls. patients: Five patients who presented with unusual clinical syndromes associated with M. avium or M. xenopi infection within weeks of experiencing large rises in CD4 cell counts following the initiation of antiretroviral therapy. RESULTS: In all patients except one, mycobacteria-specific lymphoproliferative responses rose significantly following HAART; this was temporally associated with elevations in CD4 cell counts and the occurrence of clinical disease. The patient with M. xenopi infection appeared to clear his infection subsequently without antimycobacterial therapy. In three of the four patients with M. avium infection, antimycobacterial treatment could be stopped without recurrence of infection. CONCLUSION: Our findings support the hypothesis that HAART may lead to clinically relevant inflammation as a result of restoration of specific immune reactivity against microbial pathogens that are subclinically present at the time treatment is initiated. Continuation of HAART may subsequently result in protective immunity and clearance of infection.- - - - - - - - - - ranking = 0.034972571234949keywords = intracellulare (Clic here for more details about this article) |
3/139. Disseminated mycobacterium avium complex infection presenting as osteomyelitis in a normal host.Disseminated mycobacterium avium complex (MAC) infection presenting as a painful lytic femur lesion with associated fever, night sweats and weight loss occurred in a 45-y-old woman with apparent normal immune function. Surgical drainage and 24 months of medical therapy resulted in a cure.- - - - - - - - - - ranking = 0.041094359448434keywords = mycobacterium (Clic here for more details about this article) |
4/139. Polyarthralgia-arthritis syndrome induced by low doses of rifabutin.We describe 2 cases of polyarthralgia-arthritis syndrome induced by rifabutin, an effective treatment for infections of Mycobacterium avium intracellulare complex. This syndrome has been reported with doses higher than 1 g per day when rifabutin is given in monotherapy. But our cases were treated with low doses, 300-450 mg per day, in combination with clarithromycin. The plasma concentration of rifabutin has been shown to be increased by clarithromycin, suggesting that co-prescription of clarithromycin could lead to development of rifabutin induced polyarthralgia-arthritis syndrome.- - - - - - - - - - ranking = 0.034972571234949keywords = intracellulare (Clic here for more details about this article) |
5/139. Infection by rhodococcus equi in a patient with AIDS: histological appearance mimicking Whipple's disease and mycobacterium avium-intracellulare infection.rhodococcus equi pneumonia with systemic dissemination is being reported increasingly in immunocompromised patients. This is the first case report of disseminated R equi infection with biopsy documented involvement of the large intestine. The patient was a 46 year old male with AIDS who was diagnosed with cavitating pneumonia involving the left lower lobe. R equi was isolated in culture from the blood and lung biopsies. Subsequently, the patient developed anaemia, diarrhoea, and occult blood in the stool. colonoscopy revealed several colonic polyps. Histological examination of the colon biopsies showed extensive submucosal histiocytic infiltration with numerous Gram positive coccobacilli and PAS positive material in the histiocytes. Electron microscopy showed variably shaped intrahistiocytic organisms which were morphologically consistent with R equi in the specimen. Disseminated R equi infection may involve the lower gastrointestinal tract and produce inflammatory polyps with foamy macrophages which histologically resemble those seen in Whipple's disease and mycobacterium avium-intracellulare infection.- - - - - - - - - - ranking = 1.9795200481139keywords = intracellulare infection, avium-intracellulare infection, avium-intracellulare, intracellulare (Clic here for more details about this article) |
6/139. coinfection of visceral leishmaniasis and Mycobacterium in a patient with acquired immunodeficiency syndrome.We report a case of coinfection of visceral leishmaniasis and Mycobacterium avium-intracellulare in the same lesions in the small bowel and bone marrow of a 33-year-old man with acquired immunodeficiency syndrome who complained of abdominal pain and chronic diarrhea. The duodenal mucosa and bone marrow biopsy specimens showed numerous foamy macrophages packed with two forms of microorganisms that were identified histologically and ultrastructurally as Leishmania and Mycobacterium species. Visceral leishmaniasis is rarely suspected in patients residing in nonendemic countries including the united states. It should be included in the differential diagnosis for opportunistic infection in patients with acquired immunodeficiency syndrome. An appropriate travel history is important. To our knowledge, this is the first reported case showing coinfection of visceral leishmaniasis and Mycobacterium avium-intracelluulare in the same lesion in a patient with acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 0.12004213271794keywords = avium-intracellulare, intracellulare (Clic here for more details about this article) |
7/139. An unreported side effect of topical clarithromycin when used successfully to treat Mycobacterium avium-intracellulare keratitis.PURPOSE: To report a case of Mycobacterium avium-intracellulare (MAI) keratitis successfully treated with topical clarithromycin. An unreported side effect of the topical medication is described. methods: A regular follow-up in the corneal clinic was arranged, and a pertinent literature search performed. RESULTS: The use of topical clarithromycin was successful in treating the keratitis. The patient did not complain of any ocular discomfort. Corneal subepithelial deposits that appeared during treatment with clarithromycin resolved shortly after the therapy was discontinued. CONCLUSION: This case report demonstrates that a rare infection like MAI keratitis can be successfully treated with topical clarithromycin. It also highlights the possible corneal deposition of this drug, which resolved after cessation of therapy.- - - - - - - - - - ranking = 0.60021066358972keywords = avium-intracellulare, intracellulare (Clic here for more details about this article) |
8/139. Therapeutic drug monitoring in patients with cystic fibrosis and mycobacterial disease.cystic fibrosis (CF) patients require higher dosages of many antibiotics. The relapse of tuberculosis in one CF patient, and the repeated growth of Mycobacterium avium-intracellulare in another, despite conventional therapy, raised the question of whether the serum levels of the antimycobacterial drugs were adequate. Antimycobacterial drug serum concentrations were assayed in 10 CF patients with pulmonary mycobacterial disease. serum levels below the proposed target range were seen 2 h after drug intake in the initial four patients treated: for rifampicin in 2/3, ethambutol in 3/4 and for clarithromycin in 2/3 patients, despite standard dosages. Reassays after dose adjustment and assays in six other patients showed that adequate levels were not achieved 4 h after clarithromycin in 3/5, ethambutol in 1/5, ciproflaxacin in 1/2 and ofloxacin in 2/2 patients. The patient with relapse of tuberculosis and the patient with continuous growth of M. avium-intracellulare improved and became culture negative after dose adjustment. Low drug serum levels is one reason for therapy failure in cystic fibrosis patients with mycobacterial disease. Therapeutic drug monitoring is recommended.- - - - - - - - - - ranking = 0.24008426543589keywords = avium-intracellulare, intracellulare (Clic here for more details about this article) |
9/139. Mycobacterial spindle cell pseudotumor of the brain: a case report and review of the literature.Spindle cell pseudotumors found in the skin, lymph nodes, bone marrow, spleen, lungs, and retroperitoneum have been reported recently in immunosuppressed patients, including those with acquired immunodeficiency syndrome. The authors report a similar lesion limited to the brain in a 38-year-old human immunodeficiency virus-negative man receiving steroid therapy for treatment of sarcoidosis. Histopathologically the lesions were composed of spindle and epithelioid histiocytes, small foci of necrosis, and numerous acid-fast bacilli. The acid-fast bacilli were determined by culture and polymerase chain reaction to be Mycobacterium avium intracellulare. Because of the uncommon histologic appearance of this lesion and the potential for treatment if recognized, mycobacterial spindle cell pseudotumors should be included in the differential diagnosis of spindle cell lesions in the brain in immunosuppressed patients.- - - - - - - - - - ranking = 0.034972571234949keywords = intracellulare (Clic here for more details about this article) |
10/139. Hypercalcaemia: a clue to Mycobacterium avium intracellulare infection in a patient with AIDS.Hypercalcaemia is uncommon in HIV-infected patients and should suggest a different priority for differential diagnosis than would be considered in other settings. Although hypercalcaemia has long been associated with granulomatous diseases including tuberculosis, it has only recently been recognised that patients with illness due to Mycobacterium avium intracellulare (MAI) may develop it. We report a patient with AIDS in whom unexplained hypercalcaemia was the harbinger of clinically significant MAI infection. patients with AIDS who develop hypercalcaemia should be closely evaluated for underlying MAI infection.- - - - - - - - - - ranking = 0.80699451424699keywords = intracellulare infection, intracellulare (Clic here for more details about this article) |
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