Cases reported "Opportunistic Infections"

Filter by keywords:



Filtering documents. Please wait...

1/14. Revival of tetracyclines--in the treatment of visceral leishmaniasis?

    A 37-year-old immigrant from kosovo who had been in switzerland for 2 years developed fever, cough, weight loss and malaise. serology (complement binding reaction) was positive for leptospirosis. The symptoms resolved very rapidly under vibramycin 2 x 100 mg/day for 3 weeks. However, a flare-up occurred after cessation of medication. Reexposure to tetracyclines improved the symptoms though they did not subside completely. bone marrow analysis demonstrated intracellular leishmania (amastigotes). Analysis of frozen serum preserved since the first hospitalisation and samples from the second admission were positive for leishmania (indirect fluorescence antibody test) and confirmed the diagnosis of visceral leishmaniasis. Reevaluation of the serology for leptospirosis was negative using the specific microagglutination method. Treatment with antimony for 28 days resolved all symptoms. The parasites of visceral leishmaniasis grow intracellularly and eradication may be impossible in patients with an impaired cellular immune response. Flare-ups thus recur in 60-100% of patients with organ transplants or AIDS, despite regular treatment. Our finding raises the question whether relapses are suppressed in immunocompromised patients by tetracyclines, drugs known to be well tolerated even under long-term exposure. Randomised studies are required in this setting.
- - - - - - - - - -
ranking = 1
keywords = leishmaniasis
(Clic here for more details about this article)

2/14. Visceral leishmaniasis: an opportunistic infection in haematological malignancy.

    Visceral leishmaniasis is a rare but potentially life threatening opportunistic protozoan infection in immunocompromised patients. The clinical manifestations in these patients are unusual and the diagnosis is difficult. They need prolonged treatment and are liable to have relapses. Here we report three patients with haematological malignancy (one with acute lymphoblastic leukaemia, one with chronic myeloid leukaemia, and one with myelodysplastic syndrome) complicated with visceral leishmaniasis. The clinical presentation, diagnosis, and outcome are discussed.
- - - - - - - - - -
ranking = 1
keywords = leishmaniasis
(Clic here for more details about this article)

3/14. Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule.

    Cutaneous leishmaniasis is a protozoal infection generally considered to be limited to the skin. In israel, the disease is common in geographically defined areas and is caused predominantly by leishmania major. Sporotrichoid subcutaneous spread has been reported but is uncommon. We describe a patient with rheumatoid arthritis, treated with methotrexate and prednisone, in whom numerous rheumatoid nodules concomitant with cutaneous leishmaniasis were found, mimicking sporotrichoid spread of the disease. In a rheumatoid nodule that was examined by electron microscopy, Leishmania parasites were found at intracellular and extracellular locations. This observation supports the hypothesis that cutaneous leishmaniasis parasites persist after clinical cure of the disease and may re-emerge as a result of immunosuppression.
- - - - - - - - - -
ranking = 1.1666666666667
keywords = leishmaniasis
(Clic here for more details about this article)

4/14. Absence of bone marrow amastigotes in a child with kala-azar and acute lymphoblastic leukaemia.

    Visceral leishmaniasis is suspected on the basis of clinical findings and a pancytopenic blood picture and is usually confirmed by the detection of amastigotes (Leishman-Donovan bodies) in a bone marrow aspirate. We describe a child on maintenance treatment for acute lymphoblastic leukaemia who developed visceral leishmaniasis and in whom amastigotes could not be detected in repeated bone marrow aspirates. Immunofluorescence antibody testing was positive. Immunocompromised patients in endemic areas who develop features of visceral leishmaniasis should have serological tests performed in addition to bone marrow aspiration in order to maximize the chances of making a diagnosis.
- - - - - - - - - -
ranking = 0.5
keywords = leishmaniasis
(Clic here for more details about this article)

5/14. Hemophagocytic syndrome: a rare life-threatening complication of visceral leishmaniasis in a young boy.

    The authors report a case of hemophagocytic syndrome (HPS) associated with acute visceral leishmaniasis (VL). A 4-year-old boy was admitted with high fever, hepatosplenomegaly, and pancytopenia. Elevated serum ferritin and triglyceride, low fibrinogen levels, and bone-marrow (BM) histiocytic hyperplasia with prominent hemophagocytosis were consistent with a HPS. An initial diagnosis of kala-azar was refuted because of negativity of BM aspiration and serology for this parasite, and the diagnosis HPS was made. Three months after first admission, reevaluation of the BM aspiration revealed many amastigotes of Leishmania parasites. The serology of VL became positive, finally establishing the diagnosis of VL. Although specific therapy for VL was instituted, the patient died 4 weeks after the diagnosis.
- - - - - - - - - -
ranking = 0.83333333333333
keywords = leishmaniasis
(Clic here for more details about this article)

6/14. Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with infliximab.

    Anti-TNFalpha strategies can result in significant clinical benefits in rheumatoid arthritis (RA), but with an increased rate of opportunistic infections. Visceral leishmaniasis (VL) is a severe disease that can develop in immunocompromised hosts, principally in hiv patients. VL in RA patients treated with TNFalpha antagonists is an extremely rare event, and only one case has been described. Here we report a case of VL, occurring after 9 infusions of infliximab in association with azathioprine, in a patient who developed blood cytopenia, fluctuant fever, and splenomegaly.
- - - - - - - - - -
ranking = 0.83333333333333
keywords = leishmaniasis
(Clic here for more details about this article)

7/14. 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 = 1.1666666666667
keywords = leishmaniasis
(Clic here for more details about this article)

8/14. Reactivation of dormant cutaneous Leishmania infection in a kidney transplant patient.

    BACKGROUND: leishmaniasis is an infection caused by a protozoan parasite belonging to genus Leishmania and transmitted by the phlebotomus sandfly. Clinical presentations of infection include visceral, cutaneous, and mucocutaneous forms. leishmaniasis is endemic in africa, Asia, europe, south america, and southern part of north america. This infection is extremely rare in the US and is mostly found among travelers coming from endemic areas. Cases of cutaneous and visceral leishmaniasis have been reported in organ transplant recipients in endemic areas. CASE REPORT: We describe a case of cutaneous leishmaniasis in a kidney transplant patient, originally from bolivia, who resides in the area known to be non-endemic for leishmaniasis and who is known not to travel within or outside of the US after the transplantation. RESULTS: Histologic examination of cutaneous lesion revealed extensive subcutaneous lymphohistiocytic inflammation with clusters of amastigote within histiocytes. CONCLUSION: To our knowledge, this is the first case of cutaneous leishmaniasis in a kidney transplant patient residing in the US in an area known to be non-endemic for leishmaniasis, probably after reactivation of a previously dormant infection acquired outside of the US at least 9 months prior to developing clinical symptoms.
- - - - - - - - - -
ranking = 0.83333333333333
keywords = leishmaniasis
(Clic here for more details about this article)

9/14. Visceral leishmaniasis (kala azar) in a patient with AIDS.

    A patient with hiv infection presented with multiple cutaneous Kaposi's sarcomata. biopsy of one of these showed the presence of amastigotes within an otherwise typical Kaposi's sarcoma. Further investigations proved the patient to have visceral leishmaniasis (kala azar). Visceral leishmaniasis has been reported in hiv infection but it is rare and this presentation is unique. The patient made a good response to a prolonged course of treatment with sodium stibogluconate and allopurinol.
- - - - - - - - - -
ranking = 1
keywords = leishmaniasis
(Clic here for more details about this article)

10/14. Visceral leishmaniasis in patients infected with human immunodeficiency virus (hiv).

    In an 8-month period nine patients with human immunodeficiency virus (hiv) infection were diagnosed as having visceral leishmaniasis; all diagnoses were based on cultures (eight from bone marrow and one from the skin). Visceral leishmaniasis developed before full-blown acquired immunodeficiency syndrome (AIDS) in seven patients and at the same time as or after AIDS in the other two patients. Three patients had a history of leishmaniasis. Clinical manifestations and laboratory findings were atypical. Leishmania species were cultured from samples taken from all patients; however, six patients had an insignificant antileishmanial antibody titer and Leishmania amastigotes were not seen in their bone marrow smears. Four isolates were identified by isoenzyme analysis as leishmania donovani infantum. Five patients died, including two patients who had completed at least one 3-week course of therapy with N-methylglucamine antimoniate. Screening should be done for visceral leishmaniasis in patients with hiv infection who live or travel in areas where the disease is endemic. The diagnosis of visceral leishmaniasis may frequently be missed if cultures are not done.
- - - - - - - - - -
ranking = 1.5
keywords = leishmaniasis
(Clic here for more details about this article)
| Next ->


Leave a message about 'Opportunistic Infections'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.