[Fever evolution after treatment in patients with tuberculosis and HIV infection]. / Evolución de la fiebre tras el tratamiento en pacientes con tuberculosis e infección por VIH.

OBJECTIVES: To compare the fever course after starting therapy in patients diagnosed of active tuberculosis with and without HIV infection and evaluate the usefulness of empiric antituberculous therapy in diagnosing the disease. METHODS: Review of clinical records from all patients meeting the following criteria for three years: recovery of Mycobacterium tuberculosis from any clinical sample, knowledge of serological status to HIV, initial therapy of tuberculosis, absence of ther causes of fever identified, and not being treated with drugs which potentially could interfere with the course of fever during their hospital stay. RESULTS: At admission HIV-positive patients with tuberculosis were afebrile in a significantly lower proportion than HIV-negative patients (17% vs. 54%, respectively; p < 0.001). After initiating antituberculous therapy, the median time to fever resolution was similar in both HIV-positive and HIV-negative patients (6 and 4 days, respectively). After two weeks of therapy, 25% of HIV-positive patients and 23% HIV-negative patients still had fever. No factor was identified which could predict the delay in resolution of fever. CONCLUSIONS: The course of fever was similar in both HIV-positive and HIV-negative patients after initiating antituberculous therapy. This empirical therapy may be useful in diagnosing tuberculosis, as fever resolved in the first two weeks of therapy in most patients.

[Infection by the human immunodeficiency virus in the elderly. Presentation of 13 cases]. / La infección por el virus de la inmunodeficiencia humana en el anciano. Presentación de 13 casos.

The aim of this paper is to describe the clinical characteristics of the infection by the human immunodeficiency virus (HIV) in 13 aged patients with more than 60 years of age. In all the cases, the first clinical manifestation causing the visit to the doctor was an opportunistic infection with criteria of acquired immunodeficiency syndrome (AIDS), standing out the low CD4 rate in all the patients, a delay in the diagnosis and a short survival.

[Visceral leishmaniasis located in the intestines in patients with human immunodeficiency virus infection: a report of 2 cases]. / Leishmaniasis visceral de localización intestinal en pacientes con infección por el virus de la inmunodeficiencia humana: presentación de dos casos.

We discuss two cases of visceral leishmaniasis (VL) with intestinal invasion in patients diagnosed of infection due to human immunodeficiency virus (HIV). The onset was as diarrheic manifestation associated to a constitutional syndrome, with no fever. One of the patients responded to treatment with antimonials, while the other died. References on this subject are scarce, being found on a literature search two similar cases as the ones described by us. We think that with every diarrheic process in HIV+ patients, VL diagnosis should be considered, and an intestinal biopsy should be performed.

[Tuberculosis and human immunodeficiency virus infection. A prospective study of 215 patients]. / Tuberculosis e infección por el virus de la inmunodeficiencia humana. Estudio prospectivo de 215 pacientes.

We analyze the cases of 215 adult patients affected from tuberculosis (TB) and infection due to human immunodeficiency virus (HIV) in the study period from December 6th, 1986 to January 31st of 1992. Disease affected specially the group of drug addict patients (DAP) with a 74.88%, followed by paid plasma donors (PPD) from our city with a 12.09%. Sexual transmission was the route of contamination with the HIV in 16 cases. In five cases atypical mycobacteria were detected. First-line anti-tuberculostatics drugs activity against Mycobacterium tuberculosis was excellent. A total of 17 cases with toxicity to any of these drugs were described. TB was located in the lung in 108 cases (50.23%), in 74 cases out of the lung (34.41%) and in 33 cases there was intrapulmonary as well as extrapulmonary affectation (15.34%). TB was diagnosed at the same time that a disease which met AIDS criteria in 13.49% of cases, TB was diagnosed first in 32.55% of cases, and AIDS was diagnosed before TB in only 7.91% of cases. Fever was the predominant symptom (88.84%), together with toxic status at admittance (80.47%) and deteriorated immune situation with lymphocytes count decrease (mean 1240/mm) and CD4 (mean value 134.5/mm) together with a mean raised IgA (492.85 mg/dl). Thorax radiography was normal in 34.88%. In 33 of these patients TB was localized in the lung, in 27.91% primary radiologic types were observed while in 31.16% reactivation types. In 51 cases (23.72%) tuberculosis was detected in patients (DAP) who were forwarded from the penitentiary system.(ABSTRACT TRUNCATED AT 250 WORDS)

[Mycobacteriosis from Mycobacterium szulgai in a patient with human immunodeficiency virus infection]. / Micobacteriosis por Mycobacterium szulgai en paciente con infección por el virus de la inmunodeficiencia humana.

We present a case of renal and, probably, bone mycobacteriosis by M. szulgai in a patient infected by the human immunodeficiency virus (HIV). M. szulgai is an atypical skotochromogen mycobacterium rarely described in the literature. Clinically, it is characterized by the predominance of pulmonary manifestations undistinguishables from M. tuberculosis, and rarely affecting other organs. In our environment, such mycobacterium has never been isolated in the main series published in the literature. The evolution of the patient was good, disappearing the clinical signs after the tuberculostatic treatment. The antibiogram showed resistance to rifampicine, piracinamide and ethambutol.

[Candida laryngitis and HIV infection: description of 4 cases]. / Laringitis candidiásica e infección por VIH: descripción de cuatro casos.

Candidiasic laryngitis is a very rare Candida spp infection of mucosa, appearing typically in immunosuppressed patients, mainly in patients with neoplasia, and, recently, in patients with Human Immunodeficiency Virus (VIH) infection. We present four cases of candidiasic laryngitis and HIV infection, as well as the clinical description and evolution of said cases after treatment with fluconazole. We review, as well, the cases published on the scientific literature. We maintain that in each HIV infected patient, with or without oral candidiasis, who shows dysphonia, candidiasic laryngitis should be ruled out.

[A serum immunoglobulin study in patients with tuberculosis and human immunodeficiency virus infection]. / Estudio de inmunoglobulinas séricas en pacientes con tuberculosis e infección por el virus de la inmunodeficiencia humana.

We present the immunoglobulin spectrum in a series of 156 HIV-infected patients who were affected of tuberculosis (TB) of different localization. Sixty-seven patients had lung TB, in 13 cases lung TB and an opportunistic infection were diagnosed simultaneously and in 76 cases TB was localized outside the lung. The cases were compared to 62 HIV-infected patients classified in stage 11 (CDC 1986) and to 85 cases of HIV-infected patients who suffered carinii pneumonia (PCP). The most outstanding differences were established between IgA of patients with lung TB and group PCP (p less than 0.001). IgG showed significant differences between lung TB patients and the PCP group (p less than 0.001).

[Fluconazole treatment of cryptococcal meningitis associated with HIV infection. Presentation of 4 cases]. / Tratamiento con fluconazol de la meningitis criptocócica asociada a la infección por VIH. Presentación de cuatro casos.

We present four cases of C. neoformans meningitis (CNM) in patients with Human Immunodeficiency Virus (HIV) infection treated with fluconazole p.o. at an initial dose of 400 mg followed by 200 mg/day during a follow up period ranging from 3 to 12 months, and who presented an excellent clinical evolution. When comparing them to our previous cases who were treated with Amphotericin-B in combination with 5-fluorocytosine, a decrease in mean hospital stay (p less than 0.001) and a smaller incidence of secondary effects were observed. Treatment with fluconazole seems to be an effective alternative in treatment of CNM. Future greater studies are needed to confirm this findings.

[Pneumocystis carinii pneumonia in AIDS and prolonged fever]. / Neumonía por P. carinii en el SIDA y fiebre prolongada.

Pneumonia by Pneumocystis carinii (NPC) presents a high incidence in the evolution of patients infected by the human immunodeficiency virus (HIV). Common clinical signs include fever, dry cough and dyspnea, in the presence of pulmonar interstitial affection with several degrees of hypoxemia. One hundred and sixteen patients with NPC and infection by HIV were diagnosed between December 1986 and January 1990. Criteria of persistent fever was established in 10 of them (8.7%), with normal thoracic radiography at the time of hospitalization. NPC in the adquired immunodeficiency syndrome (SIDA) may develop' with persistent fever, joining the large relation of entities manifesting in this way.

[Austrian's syndrome and infection with human immunodeficiency virus]. / Síndrome de Austrian e infección por el virus de la inmunodeficiencia humana.

A case of a patient diagnosed of Austrian' syndrome associated to HIV infection is presented. Our aim is to highlight the frequent but not enough described association to pneumonia, endocarditis and meningitis caused by Streptococcus pneumonia to increased its knowledge and permit a correct and early treatment, improving the bad prognosis of this association.