1/3. Hypercalcaemia and elevated 1,25(OH)(2)D(3) levels associated with disseminated mycobacterium avium infection in AIDS.Hypercalcaemia may complicate granulomatous diseases, such as tuberculosis and sarcoidosis, and various aids-related opportunistic infections and malignancies. We report here two patients with AIDS and disseminated mycobacterium avium infection who developed symptomatic hypercalcaemia several weeks after commencing antimycobacterial chemotherapy, and in whom inappropriately elevated 1,25(OH)(2)D(3)levels were documented. Although vitamin d supplementation may have contributed, no other cause for the hypercalcaemia was found. The biochemical and clinical similarities between these cases and other hypercalcaemic granulomatous diseases suggest a common mechanism related to macrophage activation and dysregulated vitamin d production.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/3. Disseminated cutaneous sporotrichosis associated with anergic immuno-suppression due to miliary tuberculosis.A 52-years-old policeman suffering from tuberculous meningitis, developed pseudo-umbilicated nodular skin lesions which increased rapidly in size during the course of his illness. histology revealed cutaneous sporotrichosis. Human immuno-deficiency virus infection was excluded by absence of history of exposure and repeated negative serological test for hiv antibodies. The tuberculin test was also negative. Anti-tuberculous therapy failed to prevent a fatal outcome 3 months after admission to hospital. The possibility that the usually presentation of disseminated cutaneous sporotrichosis was an opportunistic infection facilitated by immuno-deficiency accompanying anergy of miliary tuberculosis is discussed.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/3. Difficult diagnosis of infliximab-related miliary tuberculosis.The use of Infliximab in the treatment of patients with rheumatoid diseases unresponsive to conventional therapies has been reported to be complicated by opportunistic infections. We report the case of a 56-yr old female rheumatoid arthritis patient complaining of fever and respiratory symptoms 9 months after commencing Infliximab, who received no ethiologic diagnosis for the six months before admission. tuberculosis was suspected upon chest radiographic pictures and empirical treatment for miliary tuberculosis instated in the wake of microbiological confirmation. The case typifies the difficulties of diagnosing miliary tuberculosis in the immunocompromised as well as in the immunocompetent patient.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |