1/9. pneumocystis carinii pneumonia associated with acquired immunodeficiency syndrome in pregnancy: a report of three maternal deaths.acquired immunodeficiency syndrome (AIDS) has become a major public health problem in the united states. Current projections, based on seroepidemiologic data, suggest a large increase in the number of cases over the next several years. pneumocystis carinii pneumonia is the most common opportunistic infection associated with AIDS and an increase in the frequency of that illness also can be anticipated. Few cases of P carinii pneumonia associated with AIDS during pregnancy have been reported. Reported here are three such patients. All patients had been intravenous drug users and all died during the hospitalization in which the diagnosis was made. The diagnosis and management of P carinii pneumonia associated with AIDS are discussed.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/9. Lymphocytic interstitial pneumonia in patients at risk for the acquired immune deficiency syndrome.Three patients with the acquired immune deficiency syndrome (AIDS) or aids-related complex and lymphocytic interstitial pneumonia are reported. All patients presented with progressive dyspnea, nonproductive cough, fever, anorexia, weight loss, and arterial hypoxemia. Chest roentgenograms exhibited bilateral diffuse reticular-nodular densities. The diagnosis of lymphocytic interstitial pneumonia was made by fiberoptic bronchoscopy or open lung biopsy. Two patients were treated with corticosteroids, with significant improvement. The third patient died of pneumonia due to pneumocystis carinii six months after the diagnosis of lymphocytic interstitial pneumonia was established. serum antibodies to human immunodeficiency virus (hiv) were demonstrable in the two patients in whom the test was performed. Lymphocytic interstitial pneumonia is probably another pulmonary manifestation of AIDS or aids-related complex. Although the clinical presentation may be identical to the more common opportunistic infections, the treatment differs, and the prognosis may be better.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/9. Visceral leishmaniasis as an opportunistic infection in the acquired immunodeficiency syndrome.We describe the case of a woman aged 34 years infected with the human immunodeficiency virus and whose illness was complicated by visceral leishmaniasis that ultimately led to her death.- - - - - - - - - - ranking = 4keywords = opportunistic infection (Clic here for more details about this article) |
4/9. Disseminated cryptococcosis presenting as thyroiditis. Fine needle aspiration and autopsy findings.A 47-year-old diabetic ethanol and intravenous drug abuser presented with symptoms and signs indistinguishable from subacute thyroiditis. After cultures of cerebrospinal fluid grew cryptococcus neoformans, the organism was recognized in a review of a fine needle aspirate of the thyroid. Postmortem examination documented extensive thyroid inflammation and fibrosis secondary to involvement by widely disseminated C. neoformans. Fungal infection is an uncommon cause of thyroiditis, and the need for a clinical awareness of fungal thyroiditis is emphasized, as is the need to utilize special stains to detect opportunistic infections when examining cytologic preparations from immunocompromised patients.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/9. Kaposi's sarcoma in heterosexual intravenous drug users.Kaposi's sarcoma is a feature of the acquired immunodeficiency syndrome (AIDS) in male homosexuals and Haitians. In this report the authors describe six heterosexual intravenous drug users who developed Kaposi's sarcoma. They had other characteristics of AIDS including opportunistic infections (oral candidiasis, six patients; pneumocystis carinii pneumonia, two patients; genital herpes simplex, two patients; disseminated cytomegalovirus, one patient; mycobacterium avium, one patient) and inversion of the normal ratio of helper-suppressor T-cell subsets in peripheral blood lymphocytes in the two patients in whom it was determined. These observations indicate that intravenous drug users as well as Haitians and homosexual men are at risk for developing Kaposi's sarcoma as part of the acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/9. amyl nitrite may alter T lymphocytes in homosexual men.To evaluate the recent outbreak of Kaposi's sarcoma (KS) and opportunistic infections in homosexual men, clinical, virological, and immunological data on two homosexual men with KS and on fifteen healthy homosexual volunteers were collected. Both KS patients had regularly used amyl or butyl nitrite (AN); they had low helper/suppressor (H/S) T-lymphocyte ratios before chemotherapy and high titres of antibody against cytomegalovirus (CMV). Eight of the fifteen volunteers were regular AN users; seven of the eight had low H/S ratios due to larger than normal numbers of OKT8-positive suppressor cells and smaller numbers of OKT4-positive helper cells. In all eight AN users the fluorescence profile obtained with monoclonal antibody 9.6 (which detects the sheep E-rosette receptor) was bimodal, indicating a subpopulation of T cells with increased receptor density. A similar pattern was observed when OKT8, the antibody which detects cytotoxic suppressor cells, was used. Two of the seven men who did not use AN had abnormal fluorescence with reagent 9.6, and one of these also had a low H/S ratio. CMV-antibody titres were persistently high in fourteen of the fifteen healthy men, but the titres were not related to AN use of T-cell abnormalities. The data suggest that nitrites may be immunosuppressive in the setting of repeated viral antigenic stimulation and may contribute to the high frequency of DS and opportunistic infections in homosexual men.- - - - - - - - - - ranking = 2keywords = opportunistic infection (Clic here for more details about this article) |
7/9. mycobacterium avium-intracellulare: a cause of disseminated life-threatening infection in homosexuals and drug abusers.Five men developed disseminated infection with mycobacterium avium-intracellulare. These patients all lived in the new york city area and presented with their illnesses between January 1981 and September 1981; four were homosexual and one was an intravenous drug abuser. Four patients died. All five patients had defects in the cell-mediated immune response. The infections were characterized histopathologically by poor or absent granulomatous tissue reaction. Clinical isolates of M. avium-intracellulare from all five patients agglutinated commonly used antimycobacterial drugs. The spectrum of opportunistic infections among populations of homosexuals and drug abusers should be expanded to include disseminated disease due to M. avium-intracellulare.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
8/9. Acquired immune deficiency syndrome. A deadly new disease.The acquired immune deficiency syndrome (AIDS) represents a new epidemic of major proportions. risk factors include homosexuality, intravenous drug abuse, Haitian descent, and multiple transfusion in the presence of hemophilia a. The etiology of AIDS remains unknown, but there is increasing evidence implicating a transmissible infectious agent and/or multiple antigenic exposures inducing a loss of immunoregulation. In a high-risk patient, the features of weight loss, generalized lymphadenopathy, and fever should arouse suspicion of AIDS. Diagnostic confirmation includes demonstration of reduced numbers of T lymphocytes with reversal of helper-suppressor T-lymphocyte ratio, presence of unusual opportunistic infections, and a progressive downhill course. The most common infection in AIDS is pneumocystis carinii pneumonia. Treatment failures with trimethoprim-sulfamethoxazole (Bactrim, Septra) are common; pentamidine isethionate (Lomidine) may be more effective in eradicating the infection. In spite of initial improvement, recurrences of P carinii pneumonia and other opportunistic infections are common. In addition, other protozoan, viral, fungal, and atypical mycobacterial infections are frequent in patients with AIDS. Finally, rare neoplasms such as Kaposi's sarcoma and B-cell lymphoma, including primary lymphoma of the brain, are also being recognized as complications. At present there is no specific therapy for AIDS, and the disease is usually fatal. Continued research will hopefully result in immunomodulation techniques and specific vaccines to combat this serious epidemic.- - - - - - - - - - ranking = 2keywords = opportunistic infection (Clic here for more details about this article) |
9/9. Immune deficiency syndrome in children.The present epidemic of acquired immune deficiency syndrome (AIDS) was originally described in homosexual men and subsequently in intravenous drug abusers, Haitians, and hemophiliacs. Profound defects in cell-mediated immunity (CMI) are associated with Kaposi's sarcoma and a variety of serious opportunistic infections. Recently, we and others have encountered a group of children with an otherwise unexplained immune deficiency syndrome and infections of the type found in adults with AIDS. In this report, we describe eight children from the Newark, NJ, metropolitan area born into families with recognized risks for AIDS. These patients have had recurrent febrile illnesses, failure to thrive, hypergammaglobulinemia, and depressed CMI. Four of these children have died. Our experience suggests that children living in high-risk households are susceptible to AIDS and that sexual contact, drug abuse, or exposure to blood products is not necessary for disease transmission.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |