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1.
Rev. cient. Esc. Univ. Cienc. Salud ; 5(2): 56-62, jun.- dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-999430

ABSTRACT

El virus de inmunodeficiencia humana (VIH)/ síndrome de inmunodeficiencia adquirida (SIDA), afecta a millones de personas alre-dedor del mundo. En Latinoamérica y el Caribe, casi 1.9 millones de personas viven con VIH/SIDA. Se caracteriza por ser una enfermedad multisistémica en donde las enfermedades oftalmológicas se presentan en un 70% a 80% de los pacientes infecta-dos. En estos pacientes las infecciones oportunistas son la principal causa de enfer-medad ocular sin embargo, es también causa de anomalías visuales, como la ano-malía de Peter que solo se presenta 1 en un millón de personas y es la causa de más del 40% de las opacidades corneales congéni-tas. Se presenta caso de femenina de 21 años de edad, procedente de San Pedro Sula, con antecedente de virus de inmuno-deficiencia adquirida en estadio B2, por transmisión vertical, en tratamiento con anti-rretrovirales, sin antecedentes maternos infecciosos sumados al VIH. Con historia de visión borrosa, lejana y cercana en ambos ojos con mayor severidad en ojo derecho. Además, refiere cefalea, frontal, pulsátil, de predominio vespertino que se irradia hacia parietal y occipital. Al exámen físico se encuentra agudeza visual disminuida, presión intraocular en límite superior, leuco-mas corneales y gonioscopía alterada en ambos ojos. Actualmente ambos ojos esta-bles y agudeza visual mejora con gradua-ción lo que es indicativo de un pronóstico favorable...(AU)


Subject(s)
Humans , Female , Adult , Retinitis/complications , Opportunistic Infections/complications , HIV , Eye Abnormalities , Acquired Immunodeficiency Syndrome
2.
Autops. Case Rep ; 7(4): 37-41, Oct.-Dec. 2017. ilus
Article in English | LILACS | ID: biblio-905404

ABSTRACT

Disseminated toxoplasmosis is a life-threatening disease in immunocompromised individuals. Infection is contracted from handling contaminated soil, cat litter, or through the consumption of contaminated water or food. It is the third most common lethal foodborne infection in the United States. In transplant patients, most cases occur as a result of reactivation of a latent infection resulting from immunosuppression. We present a case of disseminated toxoplasmosis diagnosed at the time of autopsy. This case emphasizes the importance of maintaining a high index of clinical suspicion and active disease surveillance in this era of sophisticated diagnostic testing.


Subject(s)
Humans , Male , Middle Aged , Opportunistic Infections/complications , Toxoplasmosis/complications , Transplant Recipients , Allografts , Autopsy , Fatal Outcome , Heart Arrest/etiology , Immunosuppression Therapy , Kidney Transplantation/adverse effects , Respiratory Insufficiency/etiology , Toxoplasmosis/diagnosis , Toxoplasmosis/pathology
3.
Rev. chil. infectol ; 34(3): 280-286, jun. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-899713

ABSTRACT

There are very few reports of pediatric patients with infections by dematiaceous filamentous fungi. In this publication we report a case of invasive fungal infection of the nasal septum by Curvularia spicifera in a pediatric patient with acute myeloid leukemia. The patient presented with a painful scabby wound in the nasal vestibule. Culture and universal PCR were consistent with Curvularia spicifera. Early management with surgical debridement and bi-associated antifungal therapy achieved complete resolution of the lesions, with no evidence of dissemination and relapses. Clinical management of these fungal infections represents a challenge as the antifungal selection and duration of therapy is not yet well stablished.


Existen pocos reportes de infecciones por hongos dematiáceos en pediatría. Comunicamos el caso de una infección fúngica invasora del tabique nasal en un niño con una leucemia mieloide aguda, que se presentó como una lesión costrosa dolorosa en el vestíbulo nasal. Se realizó desbridamiento quirúrgico precoz y recibió tratamiento antifúngico biasociado, lográndose resolución completa de las lesiones, sin diseminación ni recaídas. El cultivo y la RPC universal fueron compatibles con Curvularia spicifera. El manejo de estas infecciones fúngicas representa un desafío, considerando que la elección del agente antifúngico y la duración de la terapia no están completamente establecidas.


Subject(s)
Humans , Male , Child , Ascomycota/isolation & purification , Opportunistic Infections/complications , Leukemia, Myeloid, Acute/complications , Nose Diseases/complications , Phaeohyphomycosis/complications , Neutropenia/complications , Opportunistic Infections/microbiology , Leukemia, Myeloid, Acute/microbiology , Nose Diseases/microbiology , Phaeohyphomycosis/microbiology , Neutropenia/microbiology
4.
Rev. cuba. endocrinol ; 27(1): 0-0, ene.-abr. 2016. tab
Article in Spanish | LILACS | ID: lil-780725

ABSTRACT

Introducción: el género Candida puede encontrarse colonizando el cuerpo humano, pero también puede provocar infecciones de carácter oportunista. La diabetes es considerada comúnmente un factor de riesgo para la infecciones candidósicas, dadas sus características asociadas a inmunosupresión, hiperglucemia, problemas de microvascularización, entre otros. Usualmente, para que se inicie un proceso infeccioso, es necesaria la colonización; por tanto, es importante conocer su frecuencia de portación en grupos con factores de riesgo asociados. Objetivo: determinar los porcentajes de colonización por Candida spp. en la cavidad oral y la zona interdigital del pie en pacientes diabéticos y no diabéticos. Métodos: el estudio, de carácter descriptivo, se realizó en un grupo de 85 pacientes del norte de Colombia: 46 diabéticos y 39 no diabéticos. La identificación de los aislamientos se realizó por pruebas fenotípicas, que incluyeron CHROMagar, microscopía, prueba de tubo germinal, prueba de clamidosporas y zimograma. Resultados: en los pacientes diabéticos se encontró una frecuencia de colonización por Candida spp. en la cavidad oral de 23,9 por ciento, y en el pie, de 56,52 por ciento; mientras que, para los sujetos no diabéticos, la frecuencia de colonización en la cavidad oral fue del 33,3 por ciento y en el pie del 43,58 por ciento. Adicionalmente, en el grupo de diabéticos se encontró que la frecuencia de colonización por la especie Candida albicans en la cavidad oral fue de 45,5 por ciento, mientras que en el pie fue del 11,5 por ciento. Conclusiones: los resultados obtenidos sugieren que las condiciones locales del ambiente de donde se aísla Candida spp. pueden influir en los niveles de portación y la variedad de especies, lo que podría ser más determinante que la condición de base(AU)


Introduction: Candida genus may colonize the human body but also may cause opportunistic infections. Diabetes is frequently considered a risk factor for Candida infections, given its characteristics associated to immunosuppresion, hyperglycemia, microvascularization problems and others. Generally, colonization is necessary for the starting of an infectious process; therefore, it is important to know its frequency of carriage in groups with associated risk factors. Objective: to determine the percentages of Candida spp. colonization in the oral cavity and the inter-toe area in diabetic and nondiabetic patients. Methods: the descriptive study was carried out in a group of 85 patients from the north of Colombia, that is, 46 diabetics and 39 non diabetics. The isolates were identified through phenotypical tests including CHROMagar, microscopy, germ tube test, Chlamydospore test and zymogram. Results: it was found in diabetic patients that the frequency of colonization by Candida spp. in the oral cavity was 23.9 percent and in the foot was 56.52 percent whereas in non-diabetic patients, the frequency of colonization in the oral cavity was 33.3 percent and in the foot was 43.58 percent. Additionally, it was found in the group of diabetic subjects that the frequency of colonization by Candida albicans was 45.5 percent in the oral cavity whereas that of the foot was 11.5 percent. Conclusions: the achieved results indicate that the local environmental conditions where the Candida spp. is isolated may have an impact on the levels of carriage and the variety of species, which could be more determining than the underlying condition(AU)


Subject(s)
Humans , Male , Female , Candida/isolation & purification , Candidiasis, Oral/microbiology , Diabetes Mellitus/diagnosis , Opportunistic Infections/complications , Epidemiology, Descriptive , Risk Factors
5.
Clin. biomed. res ; 36(1): 50-53, 2016. ilus
Article in English | LILACS | ID: lil-788741

ABSTRACT

Strongyloides stercoralis is an intestinal nematode that commonly causes chronic or asymptomatic infection, but in some situations, especially in immunosuppressed patients, infection by this parasite can manifest with extreme severity and high mortality. Hyperinfection syndrome and disseminated strongyloidiasis are two serious, life-threatening presentations associated with immunosuppression. This paper aims to report a case of duodenal strongyloidiasis that was associated with malabsorption syndrome and evolved to hyperinfection.


Subject(s)
Humans , Animals , Male , Opportunistic Infections/complications , Strongyloides stercoralis , Strongyloidiasis
6.
Einstein (Säo Paulo) ; 13(2): 310-318, Apr-Jun/2015. tab
Article in English | LILACS | ID: lil-751427

ABSTRACT

ABSTRACT Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively impact the number and outcomes of heart transplants.


RESUMO O transplante cardíaco é atualmente a abordagem cirúrgica definitiva padrão-ouro no tratamento da insuficiência cardíaca refratária. No entanto, a escassez de doadores limita a realização de um número maior de transplantes cardíacos, situação em que vem aumentando a utilização de dispositivos de assistência circulatória mecânica. Com indicações e contraindicações bem estabelecidas, além de diagnóstico e tratamento de rejeição, por meio de protocolos definidos de imunossupressão, os resultados do transplante cardíaco são muito favoráveis. Dentre as complicações precoces que podem impactar a sobrevida, destacamos a disfunção primária do enxerto, a disfunção do ventrículo direito, rejeição e infecções; já as complicações tardias incluem a doença vascular do enxerto e as neoplasias. Apesar das dificuldades para realização do transplante cardíaco, em especial pela escassez de doadores e pela elevada mortalidade em fila de espera, no Brasil, existe um grande potencial, tanto no aumento de doadores efetivos, quanto na utilização de dispositivos de assistência circulatória, o que pode vir a impactar positivamente no número e nos resultados do transplante cardíaco.


Subject(s)
Humans , Postoperative Complications , Opportunistic Infections/complications , Heart Transplantation , Primary Graft Dysfunction/complications , Graft Rejection/complications , Heart Failure/surgery , Tissue Donors/supply & distribution , Brazil , Chagas Cardiomyopathy/surgery , Chagas Cardiomyopathy/complications , Heart-Assist Devices , Heart Transplantation/methods , Heart Transplantation/trends , Immunosuppression Therapy/adverse effects , Immunosuppression Therapy/methods , Graft Rejection/classification , Graft Rejection/physiopathology , Neoplasms/complications , Neoplasms/chemically induced
9.
Rev. Soc. Bras. Med. Trop ; 45(6): 768-769, Nov.-Dec. 2012. tab
Article in English | LILACS | ID: lil-661084

ABSTRACT

We report a severe case of diarrhea in a 62-year-old female HIV-negative patient from whom Giardia lamblia and Isospora belli were isolated. Because unusual and opportunistic infections should be considered as criteria for further analysis of immunological status, laboratory investigations led to a diagnosis of common variable immunodeficiency (CVID). This is the first reported case of isosporiasis in a patient with CVID and illustrates the importance of being aware of a possible link, particularly in relation to primary immunodeficiency.


Trata-se de relato de caso de uma paciente de 62 anos, sexo feminino, HIV negativo apresentando um quadro grave de diarréia, sendo isolados Giardia lamblia e Isospora belli. Infecções incomuns e oportunistas devem ser consideradas como um sinal para alerta para que se analise o sistema imunológico. O diagnóstico de imunodeficiência de comum variável foi realizado após investigação. Este é o primeiro caso relatado de isosporíase em pacientes com imunodeficiência comum variável e mostra a importância de estar alerta tambem em relação a imunodeficiências primárias.


Subject(s)
Female , Humans , Middle Aged , Common Variable Immunodeficiency/complications , Giardiasis/complications , Isosporiasis/complications , Opportunistic Infections/complications , Common Variable Immunodeficiency/diagnosis , Diarrhea/parasitology , Feces/parasitology , Giardiasis/diagnosis , Isosporiasis/diagnosis , Opportunistic Infections/diagnosis , Severity of Illness Index
10.
Biomédica (Bogotá) ; 32(2): 179-181, abr.-jun. 2012. ilus
Article in English | LILACS | ID: lil-656825

ABSTRACT

Acinetobacter skin and soft tissue infection outside of the traumatic wound setting are rare occurrences. The majority of cases occur in the presence of significant comorbilities and by Acinetobacter baumanii. Herein a case is reported of community-onset, health-care-associated, non-traumatic cellulitis caused by Acinetobacter, species junii-johnsonii with bacteremia. This is the first reported case of Acinetobacter junii-johnsonii skin and soft tissue infection. Hemorrhagic bullae might be one of the clinical features of Acinetobacter cellulitis.


La infección de piel y tejidos blandos por Acinetobacter no relacionada con trauma es una presentación inusual. La mayoría de los casos descritos presentan enfermedades concomitantes y son causados por Acinetobacter baumanii. Se describe un caso de celulitis no traumática por A. junii-johnsonii con bacteriemia, de inicio en la comunidad y asociado con el tratamiento médico. De acuerdo con nuestro conocimiento, éste sería el primer caso reportado de infección de tejidos blandos y piel por A. junii-johnsonii. La vesícula hemorrágica podría ser una característica clínica de celulitis por Acinetobacter.


Subject(s)
Humans , Male , Middle Aged , Acinetobacter Infections/microbiology , Acinetobacter/isolation & purification , Cellulitis/microbiology , Opportunistic Infections/microbiology , Acinetobacter Infections/complications , Acinetobacter Infections/diagnosis , Acinetobacter Infections/drug therapy , Adenocarcinoma/complications , Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Anti-Bacterial Agents/therapeutic use , Bacteremia/complications , Bacteremia/drug therapy , Bacteremia/microbiology , Coinfection , Cellulitis/complications , Cellulitis/diagnosis , Cellulitis/drug therapy , Community-Acquired Infections/complications , Community-Acquired Infections/diagnosis , Community-Acquired Infections/drug therapy , Community-Acquired Infections/microbiology , Drug Therapy, Combination , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Opportunistic Infections/complications , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/radiotherapy , Serratia Infections/complications , Serratia Infections/drug therapy , Serratia Infections/microbiology , Serratia marcescens/isolation & purification , Shock, Septic/etiology , Shock, Septic/therapy , Spinal Cord Injuries/complications , Spinal Fractures/complications , Staphylococcal Infections/complications , Thoracic Vertebrae/injuries , Urinary Tract Infections/complications , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology
11.
Rio de Janeiro; s.n; 2012. 95 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: lil-691527

ABSTRACT

A proporção de idosos portadores da síndrome da imunodeficiência adquirida (aids) tem aumentado de maneira importante nos últimos anos e, até a presente data, existem poucos estudos que abordam a infecção nessa população especial. As particularidades imunológicas decorrentes do fenômeno da imunossenescência podem acarretar mudanças significativas na evolução da infecção pelo HIV, bem como na resposta ao tratamento. O objetivo maior desta Tese foi avaliar o impacto da idade na recuperação funcional do sistema imune de pacientes com aids acima de 55 anos, quando tratados adequadamente com terapia anti-retroviral, caracterizando a resultante imunológica da idade avançada e da infecção pelo HIV. Para tanto, foram estudados quatro grupos experimentais: indivíduos jovens saudáveis ou com aids, e indivíduos acima de 55 anos saudáveis ou com aids. Todos os pacientes com aids estavam recebendo terapia anti-retroviral, em sucesso terapêutico. No primeiro artigo apresentado, avaliamos resposta linfoproliferativa e produção de citocinas in vitro e resposta humoral in vivo mediante desafio antigênico com toxóide tetânico (TT) em indivíduos previamente vacinados contra o tétano. Os resultados mostraram deficiências imunológicas significativas relacionadas à idade avançada no que diz respeito a produção de IgG anti-TT, resposta linfoproliferativa e produção de IFN-y. Em contrapartida, a produção de IL-10 foi significativamente maior nos indivíduos acima de 55 anos, infectados ou não pelo HIV. No segundo artigo, foram caracterizadas as subpopulações de células T mediante estímulo policlonal ou específico com antígenos do envelope do HIV (Env). Em culturas não-estimuladas de PBMC do grupo com aids e idade avançada, observamos frequência reduzida de células T naive e de memória central, associada a aumento de células T efetoras. Quando estimuladas policlonalmente, essas culturas apresentaram deficiência na produção de IFN-y e hiperprodução de IL-10, como na resposta ao TT...


The proportion of aged persons living with the acquired immunodeficiency syndrome (aids) has importantly increased in recent years and, up to the present moment, there are few studies that address the infection in this particular population. The immunological nuances resulting from the immunosenescence phenomenon may promote significant alterations in the clinical course of HIV infection, as well as in treatment response. The major purpose of this Thesis was to evaluate the impact of age on the functional immune recovery in aids patients aged more than 55 years, when adequately treated with anti-retroviral therapy, characterizing the immunological result of advanced age and HIV infection. Thus, four experimental groups were enrolled: healthy or HIV-infected young adults, and healthy or HIV-infected adults over 55 years old. All the HIV-infected patients had diagnosis of aids and were under anti-retroviral treatment with therapeutic success. In the first presented article, we evaluated the lymphoproliferative response and cytokine production in vitro and humoral response in vivo, after antigenic challenge with tetanus toxoid (TT) in previously immunized individuals against tetanus. The results revealed significant age-related immunological impairments concerning anti-TT IgG production, lymphoproliferative response and production of IFN-y. On the other hand, the production of IL-10 significantly higher in individuals aged more the 55 years, HIV-infected or not. In the second article, T cell subsets were characterized after polyclonal activation or specific stimulus with antigens derived from the HIV envelope (Env). In fresh unstimulated PBMC cultures obtained from the aged aids patients, there was a reduced frequency of naïve and central memory T cells, associated with increased frequency of effector T cells. When polyclonally stimulated, these cultures showed deficient production of IFN-y and hyperproduction of IL-10, like in response to TT...


Subject(s)
Humans , Male , Female , Aging/immunology , HIV Infections/immunology , /immunology , Aged , Antiretroviral Therapy, Highly Active , Cellular Senescence/immunology , Anti-HIV Agents/therapeutic use , Opportunistic Infections/complications , Phenotype , Immune System/physiology , Treatment Outcome , Tetanus Toxoid/immunology
12.
Yonsei Medical Journal ; : 863-865, 2011.
Article in English | WPRIM | ID: wpr-182764

ABSTRACT

This is a case report on a 35-year-old man with acute myelogenous leukemia who presented fever and intermittent mucoid loose stool to the emergency center. He had been taking voriconazole for invasive pulmonary aspergillosis. The flexible sigmoidoscopy was consistent with the diagnosis of pseudomembranous colitis.


Subject(s)
Adult , Antifungal Agents/adverse effects , Enterocolitis, Pseudomembranous/chemically induced , Humans , Invasive Pulmonary Aspergillosis/complications , Leukemia, Myeloid, Acute/complications , Male , Opportunistic Infections/complications , Pyrimidines/adverse effects , Triazoles/adverse effects
13.
Rev. chil. infectol ; 27(4): 302-307, ago. 2010. ilus
Article in Spanish | LILACS | ID: lil-567543

ABSTRACT

Introducción: La aspergilosis invasora (AI) es una infección oportunista grave en pacientes inmunocompro- metidos. Pacientes receptores de transplantes y oncológicos representan el grupo de mayor riesgo. El tratamiento antifúngico involucra hospitalización prolongada y altos recursos económicos. Objetivo: Estimar los costos involucrados en el tratamiento de la AI como complicación intercurrente en pacientes con cáncer. Pacientes y Método: Estudio caso-control, retrospectivo. Estima el costo del tratamiento de AI en pacientes pediátricos oncológicos del Hospital Luis Calvo Mackenna durante los años 2007 y 2008. Resultados: Se incluyeron 13 pacientes con AI y sus respectivos 13 controles. El costo atribuible de la hospitalización en aquellos pacientes que cursaron con AI fue de US $23.600. El costo atribuible para cada indicador fue: US $16.500 para días de hospitalización; US $7.000 para medicamentos antifúngicos y US $100 para galactomanano sérico. Discusión: En este estudio, el costo del tratamiento de AI se debe principalmente a la estadía hospitalaria y fármacos antifúngicos. Encontramos tres pacientes que desarrollaron AI estando en ambiente protegido.


Introduction: Invasive aspergillosis (IA) is a serious opportunistic infection in immunocompromised patients. Transplant recipients and patients with cancer represent the highest risk group. The antifungal treatment involves prolonged hospitalization and high economic resources. Objective: to estimate costs represented by IA as an intercurrent complication of oncologic treatment. Patients and Method: Retrospective case-control study. Estimation of the cost of treatment in pediatric oncologic patients with IA in the Hospital Luis Calvo Mackenna during the years 2007-2008 was done. A control for each case of IA paired by sex, age, number of diagnosis and clinical department was selected. Results: There were 13 patients during the observation period. The attributable cost of treatment of aspergillosis was US $ 23,600 and the cost for each indicator was: hospital days US $ 16,500; antifungal therapy US $ 7,000; and serum galactomannan US $ 100. Discussion: In this study, the cost of treating IA is mainly due to hospitalization and antifungal medications. Three patients acquired IA in spite of staying in a protected environment.


Subject(s)
Adolescent , Child , Female , Humans , Male , Antifungal Agents/economics , Antigens, Fungal/economics , Aspergillosis/economics , Health Care Costs/statistics & numerical data , Neoplasms/complications , Opportunistic Infections/economics , Antifungal Agents/therapeutic use , Antigens, Fungal/therapeutic use , Aspergillosis/complications , Aspergillosis/drug therapy , Case-Control Studies , Chile , Cross Infection/economics , Immunocompromised Host , Mannans/blood , Mannans/economics , Opportunistic Infections/complications , Opportunistic Infections/drug therapy , Retrospective Studies
14.
Gastroenterol. latinoam ; 21(2): 271-275, abr.-jun. 2010.
Article in Spanish | LILACS | ID: lil-570022

ABSTRACT

Las infecciones bacterianas constituyen una complicación frecuente y severa en pacientes cirróticos debido a la existencia de alteraciones inmunológicas diversas, traslocación bacteriana y una mayor respuesta inflamatoria. La producción aumentada de citoquinas proinflamatorias, óxido nítrico y otros mediadores favorece el desarrollo de otras complicaciones, tales como deterioro hemodinámico, insuficiencia renal y encefalopatía hepática. Los efectos hemodinámicos de los mediadores inflamatorios son capaces de acentuar las alteraciones de la circulación sistémica y renal propias de la cirrosis. La insuficiencia renal en pacientes con sepsis no relacionada a peritonitis bacteriana espontánea tiene mal pronóstico incluso en casos reversibles y el índice MELD pareciera ser un buen predictor en este sentido. Estudio recientes sobre encefalopatía hepática sugieren que la respuesta inflamatoria y sus mediadores pueden ser importantes en la modulación de los efectos del amonio sobre el cerebro en los pacientes con cirrosis. El diagnóstico y tratamiento oportuno de la infección permiten mejorar el pronóstico en estos pacientes. La relación entre infección y hemorragia digestiva es estrecha, fundamentando el uso de antibióticos profilácticos. El uso de albúmina en cirróticos con infecciones diferentes a peritonitis bacteriana espontánea no ha demostrado reducir la incidencia de insuficiencia renal ni la mortalidad.


Bacterial infections are a frequent and severe complication in cirrhotic patients due to the existence of multiple immune alterations, bacterial translocation and increased inflammatory response. Increased production of proinflammatory cytokines, nitric oxide and other mediators promotes the development of other complications such as hemodynamic deterioration, renal failure and hepatic encephalopathy. Hemodynamic effects of inflammatory mediators are able to increase changes of systemic and renal circulation, typical of cirrhosis. Renal failure in patients with sepsis unrelated to spontaneous bacterial peritonitis has a poor prognosis, even in reversible cases; MELD score might be a good predictor in this regard. Recent studies about hepatic encephalophaty suggest that inflammatory response and its mediators may be important in modulating the effect of ammonia on the brain of the cirrhotic patient. Early diagnosis and treatment of the infection can improve the prognosis in these patients. The relationship between infection and gastrointestinal bleeding is narrow, justifying the use of prophylactic antibiotics. The administration of albumin to patients with cirrhosis and infections other than spontaneous bacterial peritonitis has not shown to reduce the incidence of renal failure or mortality.


Subject(s)
Humans , Liver Cirrhosis/complications , Bacterial Infections/complications , Bacterial Physiological Phenomena , Bacterial Translocation , Liver Cirrhosis/physiopathology , Liver Cirrhosis/immunology , Hepatic Encephalopathy/etiology , Gastrointestinal Hemorrhage/etiology , Bacterial Infections/therapy , Opportunistic Infections/complications , Renal Insufficiency/etiology , Inflammation Mediators/physiology
15.
Actual. SIDA ; 17(63): 24-27, mar. 2009. tab, ilus
Article in Spanish | LILACS | ID: lil-521991

ABSTRACT

Entre un 40-90% de los pacientes que adquieren la infección por HIV presentan un conjunto de síntomas durante el periodo de la seroconversión, habitualmente denominado "Síndrome Retroviral Agudo" (SRA)...


It is estimated that between 40 and 90% of HIV infected patients experience some sympotoms during HIV seroconversion, attributable to an acute retroviral syndrome (ARS)...


Subject(s)
Humans , Male , Adult , AIDS Serodiagnosis , Opportunistic Infections/complications , HIV Seropositivity/diagnosis , Tuberculosis, Pulmonary/mortality , Tuberculosis, Pulmonary/pathology , Tuberculosis, Pulmonary/therapy
16.
Indian J Pathol Microbiol ; 2008 Apr-Jun; 51(2): 294-5
Article in English | IMSEAR | ID: sea-73707

ABSTRACT

Solid organ transplantation is becoming increasingly common in the treatment of end-stage organ failure. However, despite improvements in patient and allograft survival, immunosuppression-induced compromised cell-mediated immunity predisposes transplant recipients to opportunistic infections. We describe a case of mixed opportunistic lung infection in the form of cytomegalovirus pneumonia and mucormycosis in a renal transplant recipient. Prompt recognition and treatment of infection is imperative for successful transplantation.


Subject(s)
Adult , Cytomegalovirus Infections/complications , Humans , Immunosuppressive Agents/adverse effects , Kidney Transplantation , Lung Diseases, Fungal/complications , Male , Mucormycosis/complications , Opportunistic Infections/complications , Pneumonia, Viral/complications
17.
LJM-Libyan Journal of Medicine. 2008; 3 (1): 49-51
in English | IMEMR | ID: emr-146624

ABSTRACT

Invasive fungal infections usually affect patients with immunodeficiencies and very rarely patients with no known or identifiable risk factors. Diagnosis could be delayed in patients without previously known immunodeficiencies due to a low index of suspicion, leading to a delay in treatment and a potential poor outcome. We report a case of a postpartum woman with no history of immuno-compromised disease who developed left hemiparesis with evidence of invasive aspergollosis affecting the nervous system, and leading to fatal outcome. The patient had a mass-like lesion in the neuroimaging with soft tissue shadowing in the chest x-ray leading to initial diagnosis of tuberculosis. The brain biopsy showed changes consistent with a diagnosis of aspergillosis. The source of the aspergillus infection was not clear. Aspergillus infection should be considered in patients with no identifiable immunodeficiencies who have abnormal brain imaging and chest x-ray, as early treatment may alter the outcome


Subject(s)
Humans , Female , Immunocompromised Host , Aspergillosis/complications , Acquired Immunodeficiency Syndrome/microbiology , Central Nervous System Diseases/microbiology , Opportunistic Infections/complications
19.
Article in English | WPRIM | ID: wpr-7454

ABSTRACT

Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS (acquired immune deficiency syndrome). Pulmonary involvement of MAC may range from asymptomatic colonization of the respiratory tract to invasive parenchymal or cavitary disease. However, endobronchial lesions with MAC infection are rare in immunocompetent and immunosuppressed hosts. Here, we report MAC infection presenting as an endobronchial mass in a patient with AIDS.


Subject(s)
Acquired Immunodeficiency Syndrome/complications , Adult , Antitubercular Agents/therapeutic use , Bronchial Diseases/complications , Bronchoscopy , Humans , Male , Mycobacterium avium Complex , Mycobacterium avium-intracellulare Infection/complications , Opportunistic Infections/complications , Tomography, X-Ray Computed
20.
Article in English | IMSEAR | ID: sea-38295

ABSTRACT

OBJECTIVES: Invasive aspergillosis (IA) is among the most common invasive fungal infections in neutropenic patients with hematological disorders in the authors' institution, King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand Previous studies have reported the Aspergillus galactomannan enzyme immunosorbent assay (GMEIA) may be a useful diagnostic tool for IA. The authors evaluated the performance of the GM EIA for the diagnosis and monitoring of the course of IA in KCMH. MATERIAL AND METHOD: The authors prospectively performed the study from June 2002 to January 2004 in a consecutive series of adult neutropenic patients with hematological disorders who were at risk for developing IA. During hospitalization, serum galactomannan levels were measured once or twice weekly using the Platellia Aspergillus EIA test kit. The sensitivity and specificity of the GM EIA were calculated according to the proportion of patients with true and false positive and negative tests. RESULTS: There were 50 treatment episodes in 44 patients with 5 proven, 12 probable, and 33 possible or no IA. The cutoff GM index of > 0.75 was determined with a sensitivity of 94.1% and a specificity of 78.8%. There was a close relationship between clinical outcome and the kinetics of GM indices. CONCLUSION: The GM EIA is a useful diagnostic toolfor the diagnosis and monitoring of the course oflA in the presented institute.


Subject(s)
Adolescent , Adult , Aged , Antigens, Fungal/blood , Aspergillosis/complications , Biomarkers/blood , Enzyme-Linked Immunosorbent Assay/methods , Female , Hematologic Diseases/complications , Humans , Immunocompromised Host , Male , Mannans/blood , Middle Aged , Neutropenia/complications , Opportunistic Infections/complications , Prospective Studies , Reagent Kits, Diagnostic , Risk , Sensitivity and Specificity
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