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1/250. 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.
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ranking = 1
keywords = intracellulare, avium
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2/250. arthritis due to mycobacterium fortuitum.

    mycobacterium fortuitum is classified as a rapidly growing mycobacterium (RGM) according to the Runyon classification. RGM are increasingly being recognized as human pathogens. Joint infection due to M. fortuitum is a rare, but serious disease. This report describes a patient with acquired immunodeficiency syndrome (AIDS) and septic arthritis of the knee due to M. fortuitum in a previously normal joint with no history of surgery or intra-articular injections.
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ranking = 0.81070083859793
keywords = mycobacterium
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3/250. Successful treatment of chylous ascites secondary to mycobacterium avium complex in a patient with the acquired immune deficiency syndrome.

    chylous ascites is a rare form of ascites, the presence of which generally denotes a very poor long term prognosis. We report the case of a patient with acquired immune deficiency syndrome (AIDS) and massive chylous ascites secondary to mycobacterium avium complex (MAC) infection, identified in the ascitic fluid by a dna probe assay. With multidrug anti-MAC therapy the ascites resolved completely, and the patient has survived for >21 months. diagnosis and treatment of MAC-related chylous ascites are reviewed.
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ranking = 0.1589244198443
keywords = avium complex, avium, complex
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4/250. 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.
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ranking = 1.44737415924
keywords = avium-intracellulare, intracellulare, avium
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5/250. Haemorrhagic cystitis associated with adenovirus in a patient with AIDS treated for a non-Hodgkin's lymphoma.

    Adenovirus-induced haemorrhagic cystitis has been reported chiefly in bone marrow or kidney transplant recipients. We report here on an HIV-positive patient treated for a Burkitt's lymphoma who developed gross haematuria associated with fever and burning urination. Usual causes of haematuria were ruled out: lithiasis, urinary tract lesions, glomerulonephritis, mycobacterium and schistosoma infections, and drug toxicity. Adenovirus was detected by cellular cultures and BK/jc virus dna sequences were detected using a polymerase chain reaction method. Because BK/JC virus shedding is very common (75%) in HIV patients receiving chemotherapy, our data strongly suggest that adenovirus was responsible for the haemorrhagic cystitis in our patient. In conclusion, adenovirus should be considered as a potential cause of haemorrhagic cystitis in AIDS patients whose immunosuppression is aggravated by cytotoxic drugs.
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ranking = 0.16214016771959
keywords = mycobacterium
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6/250. 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.
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ranking = 0.83333333333333
keywords = intracellulare, avium
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7/250. Different outcome in the first two patients with an hiv-1 multinucleoside drug-resistant T69SSS insertion in spain.

    A novel multidrug-resistance mechanism has been described in human immunodeficiency virus type 1 (hiv-1), which involves the insertion of 6 bp between codons 69 and 70 in the reverse transcriptase (RT) gene. Herein, we report the first two patients in spain carrying viral populations with the 69-SS insert coupled to the T69S mutation. Both patients were selected because of the lack of signal at positions 69/70 in the LiPA RT test despite being reactive to the remaining probes on the LiPA strip. The presence of the T69SSS complex was confirmed by sequence analysis. A common feature for both subjects was their past history with zidovudine monotherapy and zidovudine plus either didanosine or zalcitabine later on in the presence of persistent virus replication. Remarkably, the introduction of triple therapy in patient 1 soon after the emergence of the insert-containing viral strain produced its total displacement, which correlated with a sustained suppression in viral load.
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ranking = 0.000101294057451
keywords = complex
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8/250. Relative caregiving. An effective option for permanency.

    Children affected by HIV/AIDS are at high risk for multiple placements as the adults in their lives are often too incapacitated to provide stable, consistent care for them. This article provides a historical overview of child caregiving, describes the complex needs of HIV/AIDS affected children and their relative caregivers, usually grandparents, and suggests that with necessary supports, placement with relatives can be a thoughtful, realistic option for permanency.
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ranking = 0.000101294057451
keywords = complex
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9/250. Isolation of cytomegalovirus-specific cytotoxic t-lymphocytes from gut-associated lymphoid tissue (GALT) of HIV type 1-infected subjects.

    cytomegalovirus (CMV) can be an important opportunistic infection in hiv-1-infected patients, particularly when the CD4 T-cell count drops below 50 lymphocytes/mm3. CMV-associated disease, including retinitis, pneumonitis, gastroenteritis, and encephalitis, is estimated to affect up to 40% of AIDS patients. We have studied the cellular immune response to CMV in gut-associated lymphoid tissue (GALT) of hiv-1-infected patients. Two patients with chronic diarrhea of unknown etiology were examined by flexible sigmoidoscopy and upper endoscopy. biopsy specimens were obtained from lymphoid-associated tissue sites in rectum and duodenum. Both patients were seropositive for CMV IgG, but had not been treated with ganciclovir, and neither had clinical signs of CMV disease. Mononuclear cell cultures were established from GALT and blood and assayed for the presence of CMV-specific CD8 T cells. CD8 T-cell phenotype and function were assessed by MHC Class I tetramer staining, using an HLA-A*0201 tetramer complex specific for peptide 495-503 (NLVPMVATV) of CMV lower matrix protein pp65, and by a standard 51Cr release assay. CMV pp65-specific cytotoxic lymphocytes (CTL) were detected in GALT and blood MNC from both patients. These results demonstrate that hiv-1-infected subjects seropositive for CMV, but without active CMV gastrointestinal disease, harbor CMV-specific CTL in intestinal lymphoid tissue. This is the first report of isolation of CMV-specific CTL in GALT and will lead to greater understanding of the pathogenesis of CMV disease in human mucosal tissue.
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ranking = 0.000101294057451
keywords = complex
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10/250. Provider issues in HIV care.

    This chapter examines the impact of HIV infection and its associated biopsychosocial complications on provider-patient relationships and addresses the implications for health care teams and organizations. Several interventions are suggested that can relieve the complex stresses that health care providers are currently experiencing as they care for HIV and AIDS patients.
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ranking = 0.000101294057451
keywords = complex
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