Pulmonary coinfection by Pneumocystis jiroveci and Cryptococcus neoformans

We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci, from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient. Our review of literature identified this coinfection as unusual presentation. Opportunistic infections associated with HIV infection are increasingly recognized. It may occur at an early stage of HIV-infection. Whereas concurrent opportunistic infections may occur, coexisting Pneumocystis jiroveci pneumonia (PCP) and disseminated cryptococcosis with cryptococcal pneumonia is uncommon. The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease. Pneumonia is the leading HIV-associated infection. We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV. Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid. In patients with < 200/microliter CD4-lymphocytes, a bronchoalveolar lavage should be performed. This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole. After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.

Pulmonary coinfection by Pneumocystis jiroveci and Cryptococcus neoformans

We communicate the diagnosis by microscopy of a pulmonary coinfection produced by Cryptococcus neoformans and Pneumocystis jiroveci, from a respiratory secretion obtained by bronchoalveolar lavage of an AIDS patient. Our review of literature identified this coinfection as unusual presentation. Opportunistic infections associated with HIV infection are increasingly recognized. It may occur at an early stage of HIV-infection. Whereas concurrent opportunistic infections may occur, coexisting Pneumocystis jiroveci pneumonia (PCP) and disseminated cryptococcosis with cryptococcal pneumonia is uncommon. The lungs of individuals infected with HIV are often affected by opportunistic infections and tumours and over two-thirds of patients have at least one respiratory episode during the course of their disease. Pneumonia is the leading HIV-associated infection. We present the case of a man who presented dual Pneumocystis jiroveci and cryptococcal pneumonia in a patient with HIV. Definitive diagnosis of PCP and Cryptococcus requires demonstration of these organisms in pulmonary tissues or fluid. In patients with < 200/microliter CD4-lymphocytes, a bronchoalveolar lavage should be performed. This patient was successfully treated with amphotericin B and trimethoprim sulfamethoxazole. After 1 week the patient showed clinical and radiologic improvement and was discharged 3 weeks later.

Cryptosporidiosis in pediatric patients

Cryptosporidium foi detectado em 21 (3,8 por cento) amostras de fezes obtidas de 553 pacientes pediatricos atendidos em nosso centro medico, com a tecnica de concentracao de Telemann (formalina-eter-centrifugacao) e coloracao de Kinyoun modificada. A media etaria da populacao com criptosporidiose (16 meninos e 5 meninas) foi de 11 meses: 15 para as meninas e 6,5 meses para os meninos; 81 por cento das idades desses pacientes foram menores de 19 meses; 76 por cento eram moradores nas zonas marginais de Buenos Aires e 71 por cento com falta de agua potavel

Acid fast filaments in stool samples from an aids patient

The presence of filamentous bacteria morphologically similar to Nocardia in a fresh stool sample from an AIDS patient with pulmonary nocardiosis is here reported. The material was submitted to our laboratory for a parasitologic examination and was stained by the Kinyoun method, revealing numerous delicate, irregularly stained, branching acid-fast filaments. Nocardia asteroides had been isolated from sputum samples of this patient. The patient was a 32 year-old HIV+ female admitted to our center on june 1997 because of productive cough, right-sided thoracic pain and weight loss. Chest X rays showed the presence of right superior lobe excavated pneumonia. This was the first time we had observed filamentous bacteria similar to Nocardia in a stool sample submitted to parasitologic examination. For similar cases, and when its presence was not detected in other specimens collected from the same patient, intestinal endoscopy and biopsy should be performed for eventual lesions and smear examination repeated with Kinyoun stain and cultures for Nocardia.

Relación entre los resultados de las precipitinas para Candida y algunos parametros clinicos / Relation between of the precipitins results to Candida and some clinical parameters

Se procesaron 268 sueros para detectar la presencia de anticuerpos y antígenos de Candida por inmunodifusión en gel de agar o contrainmunoelectroforesis. Cuarenta y dos sueros dieron resultados positivos: 37 para anticuerpos, 4 para antígeno y 1 para ambos. Fueron comparados los datos clínicos de los pacientes que tuvieron resultados positivos, con los correspondientes al total de los enfermos cuyos sueros fueron analizados. La significación estadística de las diferencias encontradas, fue determinada por el método de X2. Pudo observarse un aumento significativo de la incidencia de resultados positivos en pacientes de edad avanzada (71-80 años), en los materiales procedentes de hospitales oncológicos, de servicios de cirugía o de terapia intensiva. También fue elevada la frecuencia de resultados positivos en pacientes diabéticos, con neumopatías y con tumores sólidos. Por el contrario, la incidencia de serologías positivas fue significativamente más baja en los sueros procedentes de hospitales pediátricos, en niños de 4 a 10 años, en los portadores de leucemias y en los pacientes inmunosuprimidos