11/18. Imported malaria in an HIV-positive traveler: a case report with a fatal outcome.We report a fatal case of malaria in an HIV-coinfected nonimmune traveler. The primary cause of death is discussed. The importance of prevention of malaria in nonimmune travelers is stressed. Prevention of malaria in nonimmune travelers should be regarded as a priority area for clinical practice and operational research.- - - - - - - - - - ranking = 1keywords = travel (Clic here for more details about this article) |
12/18. histoplasmosis among human immunodeficiency virus-infected people in europe: report of 4 cases and review of the literature.We reviewed the clinical, microbiologic, and outcome characteristics of 72 patients with human immunodeficiency virus (HIV)-associated histoplasmosis (4 newly described) reported in europe over 20 years (1984-2004). Seven cases (9.7%) were acquired in europe (autochthonous), whereas the majority involved a history of travel or arrival from endemic areas. The diagnosis of progressive disseminated histoplasmosis (PDH) was made during life in 63 patients (87.5%) and was the acquired immunodeficiency syndrome (AIDS)-presenting illness in 44 (61.1%). disease was widespread in 66 patients (91.7%) and localized in 6 (8.3%), with the skin being the most frequent site of localized infection. overall skin involvement was reported in 47.2% of the patients regardless of whether histoplasmosis was acquired in africa or south america. Reticulonodular or diffuse interstial infiltrates occurred in 52.8%. The diagnosis was made during life by histopathology plus culture in 44 patients (69.8%), histopathology alone in 18 (28.5%), and culture alone in 1 (1.5%). During the induction phase amphotericin b and itraconazole (74.6%) were the single most frequently used drugs. Both drugs were also used either in combination (10.2%) or in sequential therapy (11.8%). Cumulative mortality rate during the induction phase of treatment was 15.2%. overall, 37 patients died (57.8%); death occurred early in the course in 18 (28.1%). Seven of 40 patients (17.5%) who responded to therapy subsequently relapsed. autopsy data in 13 patients confirmed the widespread disseminated nature of histoplasmosis (85%) among AIDS patients with a median of 4.5 organs involved. The results of the present report highlight the need to consider the diagnosis of PDH among patients with AIDS in europe presenting with a febrile illness who have traveled to or who originated from an endemic area.- - - - - - - - - - ranking = 0.28571428571429keywords = travel (Clic here for more details about this article) |
13/18. Visceral leishmaniasis in an HIV-infected patient: clinical features and response to treatment.We report the case of 43-year-old homosexual patient with HIV infection and a history of travel to the far east in whom visceral leishmaniasis was the first infectious complication. Symptoms were fever, malaise, weight loss, hepatosplenomegaly, generalized lymphadenopathy, and oral thrush. Laboratory abnormalities included a slight elevation of liver enzymes, impairment of liver function tests, leukocytopenia, anemia, hypergammaglobulinemia, and markedly depressed CD4( )-cell counts. Despite initially successful treatment with pentavalent antimony, a relapse of leishmaniasis occurred after 7 months. Eradication of the infection was not achieved. Treatment was continued as a palliative chronic suppressive treatment with fortnightly pentamidine infusions. The clinical course was complicated by legionella pneumonia and the development of rapidly progressing Kaposi's sarcoma. The case is presented in detail, and the influence of HIV infection on the course of leishmaniasis is discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = travel (Clic here for more details about this article) |
14/18. First case of penicillium marneffei fungemia in greece and strain susceptibility to five licensed systemic antifungal agents and posaconazole.We report the first case of penicillium marneffei infection in a Greek bisexual man who is a frequent traveler to china. Penicilliosis and AIDS were diagnosed and antifungal treatment plus highly active antiretroviral therapy were administered successfully. In nonendemic areas travel history, clinical suspicion and laboratory alertness are critical for infection management.- - - - - - - - - - ranking = 0.28571428571429keywords = travel (Clic here for more details about this article) |
15/18. hiv-2 infection in an American.hiv-2 is endemic in West africa but rare elsewhere. In the USA there have been 18 reported cases of hiv-2 infection; most identified people have been West Africans. We recently diagnosed the first case of hiv-2 infection in a native-born US citizen, a woman whose serum was found to be reactive to anti-hiv-1 enzyme immunoassay (EIA) when she attempted to donate blood in 1986. Although both hiv-1- and hiv-2-specific EIAs were reactive, the anti-hiv-2 Western blot (WB) was positive, while the anti-hiv-1 WB was positive or indeterminate on different occasions. Synthetic peptide testing was reactive for hiv-2 but not hiv-1. hiv-2 dna was detected using the polymerase chain reaction procedure. Although she had travelled to West africa, it is unclear how she became infected with hiv-2.- - - - - - - - - - ranking = 0.14285714285714keywords = travel (Clic here for more details about this article) |
16/18. histoplasmosis capsulati and duboisii in europe: the impact of the HIV pandemic, travel and immigration.The present report describes a fatal case of imported AIDS-related disseminated histoplasmosis capsulati infection associated with multiple coexisting infections, diagnosed with cultural recovery of histoplasma capsulatum var. capsulatum with a commercial radiometric mycobacterium medium. The epidemiological and clinical features of histoplasmosis capsulati and duboisii in europe are reviewed by examining also 69 documented cases of histoplasma capsulatum var. capsulatum infection (25 in AIDS patients) and 17 cases of histoplasma capsulatum var. duboisii infection (3 in HIV-infected patients), described since 1980. This draws special attention to the role played during recent years by the emergence of the HIV pandemic and the progressive intensification of travel and immigration as risk factors for this disease in our continent. AIDS patients, who are prone to multiple concurrent opportunistic infections which may share clinical and laboratory features with each other and with other HIV-associated diseases, represent the most relevant current group at risk for severe disseminated histoplasmosis, which may come to medical attention far from their place of origin.- - - - - - - - - - ranking = 0.71428571428571keywords = travel (Clic here for more details about this article) |
17/18. schistosomiasis.schistosomiasis is a curable parasitic infection that, if left untreated, can persist for 30 years even though the parasite cannot reproduce in its human host. Tissue pathology, particularly of the GI and GU tracts, is associated with the granulomatous immune response to parasite eggs. schistosomiasis is not endemic to the united states because the specific snail intermediate hosts required for transmission are absent. physicians in north america will see acute and chronic forms of schistosomiasis in travelers and former residents of endemic areas. Therapy with praziquantel is indicated for all species of schistosomes and all clinical manifestations of schistosomiasis.- - - - - - - - - - ranking = 0.14285714285714keywords = travel (Clic here for more details about this article) |
18/18. Narrative case analysis of HIV infection in a battered woman.The narrative case analysis of HIV infection in a battered woman, taken from a qualitative study of women's experiences living with HIV/AIDS, conveys unusual insights into the context of violence that surrounded this woman's exposure to HIV. In her narrative, she describes the complex web of abuse she lived with day-to-day and the road she travels with AIDS as a result. Her abuse perpetrator infected her with HIV, and the whole atmosphere of violence, annihilation of self-worth, and oppressive restrictions likely contributed to the late-stage identification and treatment of her HIV-related disease. The discussion explores how domestic violence may place battered women at increased risk of becoming HIV infected. Clinical recommendations suggest that efforts to stop the battering of women and to prevent the spread of HIV in women must be combined to offer effective protection for women.- - - - - - - - - - ranking = 0.14285714285714keywords = travel (Clic here for more details about this article) |
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