Emphysematous gastritis due to Sarcina ventriculi infection in a diabetic liver-kidney transplant recipient

Emphysematous gastritis (EG) is a rare and potentially lethal process caused by invasive, gas-producing bacteria leading to inflammation and gas dissection of the stomach. The most common etiologic agents are Clostridium infections, but other organisms, including enterobacteria, staphylococcus, and fungi have also been identified. We report the first case of EG due to Sarcina ventriculi in a solid organ transplant recipient, who presented with epigastric pain and vomiting. The patient had a history of type 1 diabetes mellitus (DM) with recurrent episodes of ketoacidosis and systemic diabetic complications, including severe gastroparesis. CT scan studies demonstrated EG with venous air, and endoscopy showed severe gastritis and ulcerations. In the gastric biopsies, abundant Sarcina ventriculi were noted in areas of mucosal/submucosal necrosis. Antibiotic treatment was instituted at admission, and subsequent endoscopy demonstrated the disappearance of Sarcina, with some improvement of the gastric inflammation; however, the patient developed septic shock with multiorgan failure and expired. This case highlights the need to consider other infectious etiologies in transplant patients, in addition to the well-known opportunistic infections.

Bacteriemia recurrente por Bordetella bronchiseptica en un paciente con trasplante de medula ósea / Bordetella bronchiseptica recurrent bacteraemia in a patient with bone marrow transplantation

Se reporta un caso de bacteriemia recurrente por Bordetella bronchiseptica en un paciente inmunocomprometido con antecedentes de trasplante alogénico de medula ósea por síndrome mielodisplásico, quien ingresó al hospital por síndrome febril. Bordetella bronchiseptica es un agente patógeno veterinario poco común en humanos que afecta principalmente a pacientes inmunocomprometidos y es causa poco frecuente de bacteriemia.

We report a case of recurrent bacteraemia caused by Bordetella bronchiseptica in an immunocompromised patient with a history of allogenic bone marrow transplantation for myelodysplastic syndrome, who was admitted to hospital with febrile syndrome. Bordetella bronchiseptica is an uncommon human pathogen which mainly affects immunocompromised patients, being a rare cause of bacteraemia.

Caracterización de las infecciones respiratorias en pacientes adultos oncológicos / Clinical characteristics of respiratory infections in patients with cancer

Introduction: Infections are common in oncology. Aim: To characterize respiratory infections in hospitalized adult cancer patients. Methods: Prospective, descriptive study of febrile adult patients in oncology at the Hospital Clínico Universidad Católica de Chile, between April 2008 and April 2009. Results: 187 episodes were evaluated. Clinical infection was recognized in 70% and 33 episodes (25%) were respiratory focus. Neoplastic disease corresponded to solid organ cancer in 77% of cases and 33% were admitted with febrile neutropenia. The upper respiratory tract infection accounted for 36% and low respiratory tract infection 65% of cases; 55% was pneumonia. Etiology of these was isolated in 39% (S. pneumoniae 2 cases, S. bovis 1, E. faecalis 1, P. jirovecii 2, S. maltophilia 1 and A. fumigatus 1). Hospital mortality for pneumonia was 22% and overall mortality 12%. Conclusions: Respiratory infections are a major focus in adult cancer patients, highlighting pneumonia. It carries high mortality and varied etiology.

Introducción: Las infecciones en oncología son frecuentes. Objetivo: Caracterizar las infecciones respiratorias en pacientes oncológicos hospitalizados. Métodos: Estudio descriptivo prospectivo de pacientes adultos oncológicos febriles en el Hospital Clínico de la Universidad Católica, entre abril de 2008 y abril de 2009. Resultados: Se evaluaron 187 episodios. Se identificó foco clínico en 70% y 33 episodios (25%) correspondieron a foco respiratorio. La patología oncológica correspondió a tumores de órgano sólido en 77% de los casos y el 33% ingresó con neutropenia febril. La infección respiratoria alta representó el 36% y baja un 65% de los casos; 55% fueron neumonía. De estos, se aisló el agente causal en un 39% (S. pneumoniae 2 casos, S. bovis 1, E. faecalis 1, P. jirovecii 2, S. maltophilia 1 y A. fumigatus 1). La letalidad en el hospital por neumonía fue 22% y la mortalidad general 12%. Conclusiones: La infección respiratoria es un motivo de consulta y hospitalización frecuente en pacientes oncológicos, destacando la neumonía. Conlleva elevada mortalidad y etiología variada.

HIV Prevalence and the Correlation of Different Opportunistic Infection with CD4 Cell Count.

In India, an opportunistic infection with HIV and associated complications accounts for considerable proportion of mortality. There exists definite CD4 cell count correlation with opportunistic infection in HIV patients. Objectives: To document the prevalence of HIV with correlation of different opportunistic infection with CD4 cell count. Material and Method: A total of 174 HIV positive patients either hospitalised or ART POD were studied for finding the spectrum of opportunistic infection and for HIV prevalence. Various samples were collected as per symptoms and clinical presentation. Result: Among opportunistic infection, most common were bacterial infection with 72.5%, followed by fungal infection 42.1% and parasitic infection with 25.8%. TB in 21 patients and candidacies in 5 patients were found in CD4 cell count <500 cell/μl followed by chronic diarrhoea with CD4 cell count <200 cell / μl. Conclusion: Prevalence of HIV infection in persons attending ICTC is 11.3%. TB is the most common opportunistic infection followed by candidacies and diarrhoea.

Estudio retrospectivo de la aplicación de la amplificación génica cualitativa en muestras biológicas para el seguimiento de la toxoplasmosis en pacientes pediátricos receptores de trasplante de células progenitoras hematopoyéticas / Retrospective study of the implementation of the qualitative PCR technique in biological samples for monitoring toxoplasmosis in pediatric patients receiving hematopoietic stem cell transplantion

La toxoplasmosis es una infección oportunista causada por el parásito Toxoplasma gondii; su infección es grave y de difícil diagnóstico en pacientes que reciben un trasplante alogénico de células progenitoras hematopoyéticas (TCPH). En el Hospital de Pediatría S.A.M.I.C. "Profesor Dr. Juan P. Garrahan" se realizó la vigilancia postrasplante de 12 pacientes receptores de TCPH mediante la técnica de PCR cualitativa. La necesidad de seguimiento de estos pacientes fue definida por el antecedente de serología positiva para toxoplasmosis en el donante o receptor y ante la imposibilidad de iniciar el uso profiláctico de trimetoprima-sulfametoxazol a causa de la condición hematológica. Dos pacientes presentaron signos de enfermedad por T. gondii con resultado de PCR positivo y recibieron tratamiento con pirimetamina-clindamicina. En otros dos, la toxoplasmosis fue causa de muerte y hallazgo de autopsia, con resultado de PCR negativo. Cuatro pacientes recibieron tratamiento contra toxoplasmosis por la detección de una PCR positiva, sin manifestaciones clínicas. En los cuatro pacientes restantes no se detectaron signos de enfermedad por toxoplasmosis, con resultados de PCR negativos durante el seguimiento. La técnica de PCR cualitativa demostró ser útil para detectar la reactivación de la toxoplasmosis en receptores de TCPH, pero tiene limitaciones para el seguimiento y la toma de decisiones clínicas en pacientes con PCR positiva que persiste en el tiempo y manifestaciones de toxicidad por el tratamiento.

Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twelve patients receiving HSCT were monitored post-transplant, by qualitative PCR at the Children's Hospital S.A.M.I.C. "Prof. Dr. Juan P. Garrahan". The monitoring of these patients was defined by a history of positive serology for toxoplasmosis in the donor or recipient and because their hematologic condition did not allow the use of trimethoprim-sulfamethoxazole for prophylaxis. During the patients' monitoring, two of them with positive PCR results showed signs of illness by T. gondii and were treated with pyrimethamine-clindamycin. In two other patients, toxoplasmosis was the cause of death and an autopsy finding, showing negative PCR results. Four patients without clinical manifestations received treatment for toxoplasmosis because of positive PCR detection. In four patients there were no signs of toxoplasmosis disease and negative PCR results during follow-up. The qualitative PCR technique proved useful for the detection of toxoplasmosis reactivation in HSCT recipients, but has limitations in monitoring and making clinical decisions due to the persistence of positive PCR over time and manifestations of toxicity caused by the treatment.

Fulminant toxoplasmic retino-choroiditis following intravitreal triamcinolone administration.

We report two cases of fulminant toxoplasmic retinochoroiditis following intravitreal triamcinolone acetonide (IVTA) administration. Case 1: A 42-year-old female received IVTA for presumed non-infectious panuveitis. Within 2 months, she developed diffuse macular retinochoroiditis with optic disc edema. Upon starting anti-toxoplasmic therapy (ATT), her intraocular inflammation resolved with catastrophic damage to the disc and macula. Case 2: A 30-year-old male received IVTA for presumed reactivation of previously scarred toxoplasmic retinochoroiditis. Despite simultaneous ATT, within 6 weeks, he developed extensive, multifocal macular retinochoroiditis. He continued to require ATT for 18 months and later underwent vitrectomy with silicone oil placement for severe epiretinal proliferation. Aqueous tap polymerase chain reactions were found positive for Toxoplasma gondii in both cases. In conclusion, IVTA administration can lead to fulminant toxoplasmic retinochoroiditis even when used with appropriate ATT. Extreme caution should be exercised while administering depot corticosteroids in eyes with panuveitis of unknown origin.

Spontaneous Resolution of Intravitreal Steroid-Induced Bilateral Cytomegalovirus Retinitis

A 73-year-old woman underwent vitrectomy and intravitreal triamcinolone acetonide (IVTA) of the right eye and cataract surgery with IVTA of the left eye, for bilateral diabetic macular edema. The patient presented with visual loss in both eyes three-months postoperatively. The fundoscopic examination revealed white-yellow, necrotic peripheral lesions in the superotemporal quadrant of both eyes. Although bilateral acute retinal necrosis was suspected, azotemia resulting from diabetic nephropathy limited the use of acyclovir. Antiviral treatment was not started. A sample of the aqueous humor for polymerase chain reaction (PCR) analysis was obtained. One week later, the PCR results indicated the presence of cytomegalovirus (CMV). Since the retinal lesions did not progress and did not threaten the macula, the patient was followed without treatment for CMV. The retinal lesions progressively regressed and completely resolved in both eyes by six months of follow-up. Patients with IVTA-induced CMV retinitis may not require systemic treatment with ganciclovir.

Infección por el virus de inmunodeficiencia humana en pediatría: [revisión] / Infection by human immunodeficiency virus in children: [review]

La infección por el virus de inmunodeficiencia humana es un problema de salud pública mundial, caracterizado por inmunosupresión progresiva que predispone al desarrollo de infecciones oportunistas y enfermedades neoplásicas. En la actualidad, la transmisión ocurre fundamentalmente por contacto sexual sin protección y por vía vertical de madre a hijo durante el embarazo, el nacimiento o la lactancia materna. Sin intervención médica específica, la tasa promedio de transmisión vertical es aproximadamente 28 a 30%. La infección puede ser asintomática por tiempo prolongado. Las manifestaciones clínicas en pacientes pediátricos son frecuentemente inespecíficas. Para el diagnóstico de la infección vertical en los primeros 18 meses de vida se requieren pruebas virológicas, ya que las pruebas serológicas rutinarias producen resultados falsos positivos, debido al paso de anticuerpos maternos por la placenta. La disponibilidad de tratamiento antirretroviral de alta eficacia ha cambiado radicalmente el curso de la enfermedad, ya que disminuye la morbilidad y la mortalidad relacionada con el virus. Sin embargo, el beneficio terapéutico más importante es la disminución del riesgo de transmisión vertical, cuando el tratamiento se administra a la madre (durante el embarazo y el nacimiento) y al recién nacido (en las primeras horas de vida). La reducción de dicho riesgo también está relacionado con el nacimiento por cesárea programada y la sustitución de la lactancia materna. El diagnóstico materno prenatal, preferiblemente en el primer trimestre del embarazo, es esencial para implementar las medidas de prevención. Aunque las estrategias preventivas se deben iniciar durante el embarazo o incluso antes, la participación del pediatra es crucial para asegurar, como mínimo, el cumplimiento de las recomendaciones durante y después del nacimiento.

Infection with human immunodeficiency virus is a global public health problem characterized by progressive immunosupression that leads to development of opportunistic infections and neoplasic diseases. At present, transmission occurs mainly by unprotected sexual contact and vertical transmission from mother to child during pregnancy, birth or breastfeeding. Without specific medical intervention, the average rate of vertical transmission is about 28 to 30%. The infection can be asymptomatic for a long time. The clinical manifestations in pediatric patients are often nonspecific. The diagnosis of vertical infection in the first months of life requires virologic tests since routine serological tests produce false positives results, due to the passage of maternal antibodies through the placenta. The availability of highly effective antiretroviral therapy has radically changed the course of the disease because it reduces morbidity and mortality related to the virus. However, the most important therapeutic benefit is the decrease of vertical transmission risk, when treatment is administered to the mother (during pregnancy and birth) and the newborn (in the first hours of life). Reducing that risk is also related to birth by planned cesarean section and replacement of breastfeeding. Maternal prenatal diagnosis, preferably in the first trimester of pregnancy, it is essential to implement prevention measures. Although preventive strategies should be initiated during pregnancy or even before, the pediatrician participation is crucial to ensure, at least, compliance with the recommendations during and after birth.

F-18 FDG PET evaluation of opportunistic infections in renal transplant recipients

Renal transplantation is the most common type of organ transplantation. However, infection is a major complication among renal transplant recipients, including pneumonia, one of the most frequent life-threatening complications of long-term immunosuppression. Invasive fungal infections are among the most common pathogens. Early diagnosis and prompt treatment of opportunistic infections are crucial in decreasing mortality. There have been cases reported where the use of F-18 Fluorodeoxyglucose (FDG) positron mission tomography (PET) was helpful in the diagnosis of fungal disease in immunocompromised patients. Here we present two of such cases.

História natural da histoplasmose / Natural history of histoplasmosis

A histoplasmose é uma doença infecciosa sistêmica causada pelo fungo Histoplasma capsulatum. Sua patogenicidade está vinculada ao estado imunológico do hospedeiro e à carga fúngica inalada. O fungo apresenta distribuição cosmopolita, instalando-se em áreas de solo rico em compostos nitrogenados, habitadas por aves e morcegos. Costumeiramente, cursa com infecção assintomática ou autolimitada, porém pode evoluir para as seguintes formas: histoplasmose pulmonar aguda, histoplasmose pulmonar crônica e histoplasmose disseminada. Destaca-se, como método diagnóstico, o isolamento de forma leveduriformes em amostra de escarro, lavado broncoalveolar, biopsia de tecido pulmonar, sendo de suma importância descartar outras possibilidades diagnósticas, sobretudo, tuberculose. O tratamento depende do quadro clínico do hospedeiro e do estado imunológico, destacando-se o uso de fármacos como itraconazol, fluconazol, anfoterecina B e, eventualmente, corticosteróides como adjuvantes.

Histoplasmosis is a systemic infectious disease caused by the fungus Histoplasma capsulatum. Its pathogenicity depends on the underlying immune status of the host and the inhaled fungal burden. The fungus is found throughout the world in areas of rich nitrogenous soil, inhabited by birds and bats. The infection is mostly asymptomatic or self-limited, but severe clinical manifestations might develop with the occurrence of accute pulmonary histoplasmosis, chronic pulmonary histoplasmosis or disseminated histoplasmosis. Diagnosis is made when yeast forms are found in sputum, bronchoalveolar lavage or pulmonary tissue biopsy. Is is of the utmost importance to establish the differentials, specially tuberculosis. Treatment indicated depends on the hos clinical picture and immune status; drugs of choice are itraconazole, fluconazole, amphothericin B and corticosteroids as adjuvants.

Burkholderia cepacia complex: virulence characteristics, importance and relationship with cystic fibrosis.

BACKGROUND: Burkholderia cepacia has been described as a cause of opportunist infections in patients with immune deficiency because of the high transmission rates. Actually the B. cepacia is subdivided in nine different genomic species that show morphological similarity, called genomovars. High mortality rates have been associated with infections caused by genomovars in susceptible patients; antibiotics are not efficient because of the high resistance level and genomic mutability. Little is known about the epidemiological traits of this bacterium; therefore, their isolation remains a relevant technical problem. AIMS: The objective of this review is to describe Burkholderia cepacia as a bacterial complex with high pathogenicity and variability of habitats. MATERIALS AND METHODS: A systematic search was realized using the international bibliographic databanks SCIELO, HIGHWIRE, PUBMED, SCIRUS and LILACS to provide a useful and practical review for the health workers that do not know this microorganism. CONCLUSIONS: Today, B. cepacia complex is a very important problem for the acquired immunodeficiency syndrome and cystic fibrosis patients. The immunodeficiency caused by these diseases is a positive factor for this microorganism to infect and kill these patients. Therefore, this opportunistic pathogen should be pointed out as a risk to these patients and hospitals all over the world must be prepared to detect and combat this bacterium.

Continuous infusion of amphotericin B: preliminary experience at Faculdade de Medicina da Fundação ABC

CONTEXTO E OBJETIVO: Pacientes neutropênicos com febre persistente podem apresentar infecções fúngicas com freqüência. A administração de anfotericina B deoxicolato tem sido padrão para estes pacientes, no entanto sua infusão endovenosa, usualmente administrada em quatro horas, pode levar a nefrotoxicidade, hepatotoxicidade e efeitos adversos relacionados à infusão, como tremores e calafrios. A literatura evidencia que o uso de anfotericina B deoxicolato em infusão contínua de 24 horas pode ser menos tóxica em relação à administração usual. O objetivo do estudo foi avaliar a eficácia, segurança e toxicidade da anfotericina B infusional contínua em pacientes onco-hematológicos após quimioterapia com neutropenia febril persistente. TIPO DE ESTUDO E LOCAL: Estudo observacional e retrospectivo de nossa experiência com anfotericina B deoxicolato em infusão contínua de 24 horas, na Faculdade de Medicina da Fundação ABC e Hospital Estadual Mário Covas, em Santo André. MÉTODOS: No período entre outubro de 2003 e maio de 2004, 12 pacientes com neoplasias hematológicas e neutropenia febril induzida por quimioterapia receberam 13 ciclos de anfotericina B deoxicolato infusional. RESULTADOS: A dose média da infusão foi de 0,84 mg/kg/dia. O uso concomitante de outras drogas nefrotóxicas ocorreu em 92% dos ciclos. Foram observados nefrotoxicidade em 30,76%, hipocalemia em 16,67%, hepatotoxicidade em 30% e efeitos adversos relacionados à infusão em 23% dos ciclos. Todos os pacientes sobreviveram aos sete primeiros dias após o início do tratamento e a resolução clínica ocorreu em 76% dos ciclos. CONCLUSÃO: A infusão contínua de anfotericina B é exeqüível para uso em nossa instituição como alternativa à infusão em quatro horas (mais tóxica) e possivelmente às caras formulações lípidicas desta droga.

Inhibitory effect of some phytochemicals in the growth of yeasts potentially causing opportunistic infections

Opportunistic infections caused by yeasts have been characterized as emerging diseases all over the world and this has caused the search for new products capable of inhibiting the survival of their etiological agents. In this study the sensitivity of some yeast potentially causing infections to `alpha´-pinene, ß-pinene, citral and engenol was avaluated. All phytochemicals showed inhibitory action on the assayed yeast strains: Candida, albicans, C. tropicalis, C. guilliermondïi, C. stellatoidea, C. krusei, C. parapsilosis and Cryptococcus neoformans, presenting their MIC values in the range of 1 and 4 por cento The phytochemicals presented effectiveness to provide high fungicide effect in a short time. These data support the possible use of some phytochemicals as useful tools to control the occurrence of opportunistic infections caused by yeasts

Infecciones en pacientes sometidos a trasplante de órgano sólido / Infections in solid organ transplant recipients

The main problems in solid organ transplant recipients are rejection and infections. The new immunosuppressive regimens have lowered the risk of rejection, however, infections continue to be one of the most important determinants for morbidity and mortality in these patients. The survival of the transplanted organ is also impacted by the different infectious diseases that occur in the post-transplant period. These infections are of viral, bacterial, fungal and parasitic origin, and their presentation occurs characteristically within well defined risk periods after the transplant. The clinical presentation is commonly atypical; therefore for optimal management, it is necessary to have a through knowledge of the epidemiology and clinical manifestations of these problems, but most importantly, the experience of the clinician in the clinical approach and early detection will result in better outcomes. We review recent information regarding the infectious diseases that affect solid organ recipients according to the type of transplant, the post-transplant, risk factors before the transplant and the type of immunosuppressive therapy used, which are the main determinants for these complications and their prognosis.

Los problemas principales en el paciente sometido a trasplante de órgano sólido (TOS) son el rechazo del órgano y las infecciones. Los nuevos esquemas inmunosupresores han disminuido el riesgo de rechazo, sin embargo, las infecciones siguen siendo uno de los determinantes más importantes de morbilidad y mortalidad en estos pacientes. La sobrevida del órgano trasplantado es impactada también por los diversos procesos infecciosos que ocurren en el periodo postrasplante. Las infecciones que afectan a estos pacientes son de origen viral, bacteriano, fúngico y parasitario y su presentación ocurre característicamente dentro de periodos bien definidos de riesgo posterior al trasplante. La presentación clínica frecuentemente es atípica, por lo que para el manejo óptimo es necesario conocer la epidemiología y las manifestaciones clínicas de estos problemas, pero sobre todo la experiencia del clínico en el abordaje y en la detección temprana resulta en un mejor desenlace. En este artículo se revisa la información reciente sobre las enfermedades infecciosas que afectan a pacientes sometidos a TOS de acuerdo con el tipo de trasplante, al periodo postrasplante, a los factores de riesgo previo al trasplante y al tipo de terapia inmunosupresora utilizada, los cuales son los principales determinantes de estas complicaciones y de su pronóstico.

Intraabdominal Cryptococcal Lymphadenitis in a Patient with Systemic Lupus Erythematosus

Cryptococcal infection is a rare, yet well recognized complication of systemic lupus erythematosus (SLE). We present a case of mesenteric and retroperitoneal cryptococcal lymphadenitis resulting in the obstruction of the stomach and proximal duodenum in a patient suffering from SLE, while recently she did not receive any immunosuppressive treatment. A 42-yr-old woman was admitted due to high fever and diffuse abdominal pain for three weeks. Abdominal computed tomography (CT) scan showed multiple conglomerated lymphadenopathies in the retroperitoneum and the mesentery resulting in luminal narrowing of the third portion of the duodenum. Cryptococcal lymphadenitis was proven by needle biopsy and she was treated with intravenous liposomal amphotericin B, followed by oral fluconazole. After fourteen-month antifungal therapies, the clinical symptoms and follow-up images improved. This case emphasize that the intrinsic immunological defects of SLE may be directly responsible for the predisposition to fungal infections.

Bacteremia due to Rhodococcus equi--a case report.

Rhodococcus equi (R. equi) primarily causes zoonotic infections affecting grazing animals and is an unusual cause of infection in immunocompetent human beings. We report a case of bacteremia due to R. equi a rare isolate in a child suffering from protein energy malnutrition

Pneumocystis carinii pneumonia after renal transplantation.

Being immuno-suppressed, renal allograft recipients are at increased risk of contracting various infectious complications. Pneumocystis carinii pneumonia (PCP) is one of the important opportunistic infection causing high morbidity and mortality in these patients. Majority of studies has reported the occurrence of PCP during 6 months to one year after renal transplantation. This communication describes occurrence of PCP in five renal allograft recipients 10 weeks to 72 months after transplantation. In view of elusive presentation, strong clinical and radiological suspicion followed by direct demonstration of the organisms is essential for early diagnosis and prompt treatment. These observations also indicate that PCP is an emerging opportunistic infection in immuno-compromised patients in tropical countries.

Ação antimicrobiana de óleos essencias sobre microrganismos potencialmente causadores de infecções oportunistas / Anti-microbial action of essential oils against microorganisms potentially causing opportunistic infections

Os processos infecciosos causados por agentes microbianos são muito frequentes no Brasil, em consequência de seu clima tropical. Esses processos afetam pele, pêlos, unhas, mucosas, tecido subcutâneo, órgãos e sistemas. Como as infecções bacterianas e fúngicas são tratadas por meio da correção de fatores predisponentes e da terapêutica medicamentosa, este estudo se propõe a avaliar o potencial antimicrobiano de óleos essenciais, obtidos de plantas medicinais, contra diversas espécies microbianas conhecidas como potencialmente causadoras de infecções oportunistas, incluindo bactérias e fungos. Os resultados evidenciaram uma proeminente atividade antimicrobiana dos óleos essenciais de Cinnamomum zeylanicum Blume a 4 por cento de Coniza bonariensis L. a 4 por cento e de Lippia alba N. E. Brown a 8 por cento, os quais inibiram o crescimento de 72 por cento, 61 por cento e 44 por cento, respectivamente, das cepas testadas, apresentando halos de inibição do crescimento microbiano entre 10 e 24 mm de diâmetro.

Epidemiology and Clinical Features of HIV Infection/AIDS in Korea

HIV infection/AIDS shows characteristic epidemiological and clinical patterns according to the region, country, and race. The epidemiological and clinical patterns of HIV infection/ AIDS in Korea was investigated by retrospectively analyzing the medical records of 176 HIV-infected persons who visited two major referral hospitals of AIDS in Korea from 1985 to April 2000. The most common transmission route was heterosexual contact (52.3%), followed by homosexual contact (23.9%). Among the opportunistic diseases, candidiasis was the most prevalent (21.6%), followed by Pneumocystis carinii pneumonia (15.9%), tuberculosis (12.5%), and CMV infection (9.1%). The most common initial AIDS-defining opportunistic disease was tuberculosis (33.3%). The most common causes of death were tuberculosis (25.7%) and Pneumocystis carinii pneumonia (25.7%). This study describes the epidemiological and clinical patterns of HIV infection/AIDS in Korea, which not only enables us to accurately understand HIV infection/ AIDS in this country, but eventually to aid in establishing effective preventive measures and treatment guidelines in Korea.