Subject(s)
Humans , Male , Female , Pregnancy , Pregnancy Complications, Infectious/virology , Zika Virus Infection/complications , Zika Virus Infection/prevention & control , Zika Virus Infection/transmission , Zika Virus Infection/epidemiology , Americas/epidemiology , Risk Factors , Epidemics , Zika Virus/pathogenicityABSTRACT
Human herpesvirus 7 (HHV-7) may cause encephalomyelitis in immune competent adults. We report two patients infected by the virus. A 34-year-old male presenting with paraparesis and a sensitive deficiency located in D6 dermatome. Cerebrospinal fluid had 35 white blood cells per mm³ and 75 mg protein per dl. A PCR-microarray examination was positive for HHV-7. The patient was treated with prednisolone and ganciclovir with full recovery. A 27-year-old male presenting with headache, fever and diarrhea. Cerebrospinal fluid analysis showed 160 cells per mm³ and 75 mg protein per dl. Viral RNA detection was positive for HHV-7. The patient was managed with analgesia and rest and was discharged with the diagnosis of viral meningitis. Our communication supports the notion that HHV-7 may be considered as pathogen factor in humans, even in immune competent ones.
Subject(s)
Adult , Humans , Male , Encephalitis, Herpes Simplex/virology , /isolation & purification , RNA, Viral/cerebrospinal fluid , Roseolovirus Infections , Diagnosis, Differential , Encephalitis, Herpes Simplex/cerebrospinal fluid , /genetics , Immunocompetence , Microarray Analysis/methods , Polymerase Chain Reaction , Roseolovirus Infections/cerebrospinal fluidABSTRACT
Objectives: To establish the etiology of pneumonia and to compare the yield of diagnostic techniques for diagnosis of Pneumocystis jiroveci and Mycobacterium tuberculosis infections in HIV-1-infected patients. Patients and Methods: Subjects underwent sputum induction and bronchoalveolar lavage (BAL). Gram, Ziehl-Neelsen, silver stain (SS) and immunofluorescense staining (IF) for P. jiroveci, fluorescent stain for mycobacteria, PCR for P. jiroveci andM. tuberculosis, aerobic, fungal and mycobacterial cultures, respiratory viruses and CMV cultures were performed on the sputum and BAL. IgM for Mycoplasma pneumoniae and Chlamydophyla pneumoniae, and Legionella pneumophila urinary antigen were also obtained. Results: Sixty patients were included. An etiologic diagnosis was made in 97 percent. Pneumocystisjiroveci was the most frequent etiology (58 percent) followed by Streptococcus pneumoniae (12 percent), and Mycobacterium avium complex (12 percent). Mycobacterium tuberculosis was found in 5 percent. Conclusions: The comparison of diagnostic methods for P. jiroveci showed a higher sensitivity of IF and SS in BAL than in sputum, however PCR was equally sensitive in both samples. With this approach a precise etiologic diagnosis was reached in the great majority of patients. The most common etiology was P. jiroveci. IF in BAL remains the gold standard for diagnosis of P. jiroveci pneumonia.
Objetivos: Establecer la etiología de la neumonía y comparar el rendimiento de diferentes técnicas para el diagnóstico de las infecciones por Pneumocystis jiroveci y Mycobacterium tuberculosis en pacientes con infección por virus de inmunodeficiencia humana (VIH). Material y Métodos: De cada paciente se obtuvo esputo inducido y se efectuó LBA. A las muestras obtenidas se les realizó tinciones de Gram, Ziehl-Neelsen, plata e inmunofluores-cencia (IF) para P. jiroveci y M. tuberculosis; reacción de polimerasa en cadena (RPC) para ambos microorganismos; cultivos aeróbicos, fúngicos, para micobacterias, virus respiratorios y citomegalovirus. También se realizó determinación de IgM de Mycoplasma pneumoniae y Chlamydophyla pneumoniae y antígeno urinario de Legionella pneumophila. Resultados: Se incluyeron 60 pacientes, lográndose diagnóstico etiológico en 97 por ciento de los casos. Pneumocystis jiroveci fue la etiología más frecuente (58 por ciento), seguida por Streptococcus pneumoniae (12 por ciento) y Mycobacterium avium complex (MAC) (12 por ciento). Mycobacterium tuberculosis fue encontrado en 5 por ciento. Conclusiones: La comparación de los métodos diagnósticos para P. jiroveci mostró una mayor sensibilidad de la IF y tinción de plata en LBA que en esputo; sin embargo, la RPC fue igualmente sensible en ambos tipos de muestras. Con esta estrategia se logró establecer etiología en la gran mayoría de los pacientes. La etiología más común fue P. jiroveci. IF en LBA sigue siendo el estándar para el diagnóstico de la neumonía por P. jiroveci.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , AIDS-Related Opportunistic Infections/microbiology , Bronchoalveolar Lavage Fluid/microbiology , Pneumonia/microbiology , Polymerase Chain Reaction , Sensitivity and SpecificitySubject(s)
Humans , Communicable Disease Control , Communicable Diseases/transmission , Travel , Vaccination , Africa , Risk FactorsABSTRACT
Background: Some infections share common modes of transmission with HIV and have the potential to change the course of the latter. Aim: To assess the prevalence of hepatitis B virus (HBV) hepatitis C virus (HCV), Treponema palladium and Toxoplasmosis gondii co-infections in HIV-1 infected patients followed at a university hospital. Material and methods: Clinical records of HIV-positive individuals were reviewed. The analysis included: demographical data, hepatitis B surface antigen (HBsAg), IgM and IgG anti-HBc, antibodies, anti-HCV antibodies, RPR or VDRL test and IgG anti Tgondii antibodies. Results: Three hundred ninety five patients (aged 16 to 89years, 359 males) were included in the review. Seventy nine percent had been tested for HBV status with HBsAg, and the global HIV-HBV co-infection prevalence was 6.1 percent. A subgroup of190 individuals were tested for HBV infection with HBsAg and IgM/IgG anti-HBc markers. Of these, 46 percent fulfilled co-infection criteria: eight with acute hepatitis B, 11 with chronic hepatitis B and 69 with inactive HBV infection. The frequency of HIV-HBV co-infection was 48 percent and 22 percent among men and women respectively (NS). HCV-HN co-infection was detected in 3 percent, syphilis-HIV co-infection in 21 percent and T gondii-HIV co-infection in 26 percent. Conclusions: In this cohort, HIV infection is accompanied by a high prevalence of other co-infections, particularly HBV among men.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , AIDS-Related Opportunistic Infections/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Syphilis/epidemiology , Toxoplasmosis/epidemiology , AIDS-Related Opportunistic Infections/diagnosis , Chile/epidemiology , Cohort Studies , Hepatitis B/diagnosis , Hepatitis C/diagnosis , Prevalence , Retrospective Studies , Syphilis/diagnosis , Toxoplasmosis/diagnosis , Young AdultABSTRACT
Se revisa la historia de la infección VIH/SIDA en los últimos 26 años, desde una perspectiva vivencial, destacando los problemas y avances conseguidos en estos años. Se plantea la situación actual de la epidemia, los logros y desafíos que se están viviendo en la actualidad.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome/etiology , Acquired Immunodeficiency Syndrome/history , Acquired Immunodeficiency Syndrome/drug therapy , Zidovudine/therapeutic useABSTRACT
Se presenta una síntesis del desarrollo de los antimicrobianos, abarcando la antigüedad y los tiempos modernos, incluyendo la era pre-antibiótica, el periodo del explosivo desarrollo de antibióticos y el futuro en el cual se plantea los riesgos del incremento de la resistencia y el menor interés de la industria en invertir en la investigación de nuevos compuestos.
Subject(s)
Humans , Anti-Bacterial Agents/history , Pharmacology, Clinical/trends , Drug Resistance, MicrobialABSTRACT
Aim: To compare the efficacy of imipenem - cilastatine and ceftazidime - amikacin in the treatment of febril neutropenic patients. Design: Open prospective and randomized clinical study. Patients: 52 patients (26 females) aged 16 to 80 years old with 60 episodes of neutropenia were studied. They were randomly assigned to receive Imipenem - cilastatine in doses of 500 mg iv qid or the combination of ceftazidime 1 to 1.5 g iv tid and amikacin 7.5 mg/kg iv bid. Results: Global response to initial therapy was 53 percent in patients receiving imipenem - cilastatine and 37 percent in those receiving ceftazidime - amikacin (p=ns). When other antimicrobial were added, a 90 and 85 percent infection eradication success was achieved respectively. Six febrile episodes in the group receiving imipenem - cilastatine and 12 episodes in tha group receiving ceftazidime - amikacin had Gram positive cocci as the sole treatment outcome. Three patients receiving imipenem - cilastatine (10 percent) and 4 receiving ceftazidime - amikacin (13 percent) died. Superinfections and toxicity related to antibiotics were minimal in both groups. Conclusions: imipenem - cilastatine and the combination of ceftazidime with amikacin were equally effective in the treatment of febril episodes in neutropenic patients