RESUMO
OBJECTIVE: To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil. METHODS: Retrospective, comparative study. RESULTS: Among a total of 123 consecutive HIV infected patients, 20 men (20.6 percent) and 6 women (23.1 percent) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7 percent of coinfected patient versus 9.2 percent of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm³, versus 140 ± 177cells/mm³, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1. CONCLUSION: Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.
Assuntos
Adulto , Feminino , Humanos , Masculino , Infecções Oportunistas Relacionadas com a AIDS/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HTLV-II/complicações , Estrongiloidíase/etiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Terapia Antirretroviral de Alta Atividade , Infecções por HTLV-I/complicações , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-I/imunologia , Infecções por HTLV-II/diagnóstico , Infecções por HTLV-II/imunologia , Estudos Retrospectivos , Fatores de Risco , Estrongiloidíase/diagnóstico , Estrongiloidíase/imunologiaRESUMO
The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Assuntos
Idoso , Animais , Humanos , Masculino , Evolução Fatal , Hospedeiro Imunocomprometido , Larva , Escarro , Strongyloides/crescimento & desenvolvimento , Estrongiloidíase/etiologia , Superinfecção/parasitologiaRESUMO
A case of Strongyloides hyperinfection syndrome, associated with corticosteroid therapy is described here. A 69-year-old male patient was admitted with a minor stroke. A history of headache arid a markedly elevated ESR prompted a temporal artery biopsy, which was consistent with temporal arteritis. Treatment was started with prednisolone 60 mg per day and the patient was discharged for follow-up. He was readmitted with a dense hemiplegia arid high fever. Blood culture grew E.co/i. He rapidly deteriorated arid died with evidence of disseminated intravascular coagulation and acute respiratory distress syndrome. Wet smears of sputum were positive for larvae of Strongyloides sterco ru/is, suggesting generalised infection. The importance of early diagnosis arid therapy, and screening methods for detection of parasites in stool are discussed
Assuntos
Humanos , Masculino , Estrongiloidíase/etiologia , Esteroides/efeitos adversos , Strongyloides stercoralis/parasitologia , Strongyloides stercoralis/patogenicidadeRESUMO
Relato de paciente com imunodeficiencia rara e manifestacao gastrointestinal incomum. Paciente...
Assuntos
Humanos , Masculino , Adulto , Enteropatias Parasitárias/complicações , Estrongiloidíase/etiologia , Imunodeficiência de Variável Comum/etiologia , Vômito , Dor AbdominalRESUMO
Apresenta-se caso de criança com estrongiloidíase disseminada com evolução fatal. Enfatizam-se os fatores de risco, as manifestações clínicas, os meios diagnósticos e o tratamento. Recomenda-se a investigação de Strongyloides stercoralis em crianças severamente mal nutridas, doenças neoplásicas, AIDS ou em uso de corticoterapia prolongada
Assuntos
Humanos , Masculino , Lactente , Estrongiloidíase/etiologia , Estrongiloidíase/fisiopatologia , Estrongiloidíase/terapia , Fatores de Risco , Strongyloides stercoralis/patogenicidade , Interações Hospedeiro-ParasitaRESUMO
Os autores apresentam um caso de esporotricose verrucosa em paciente do sexo feminino, branca, 23 anos de idade e história de três anos de evoluçäo; havia concomitância de quadro clínico e laboratorial de doença de Cushing