Pneumocystis jirovecii pneumonia in developing countries.

Pneumocystis pneumonia (PcP) is a serious fungal infection among immunocompromised patients. In developed countries, the epidemiology and clinical spectrum of PcP have been clearly defined and well documented. However, in most developing countries, relatively little is known about the prevalence of pneumocystosis. Several articles covering African, Asian and American countries were reviewed in the present study. PcP was identified as a frequent opportunistic infection in AIDS patients from different geographic regions. A trend to an increasing rate of PcP was apparent in developing countries from 2002 to 2010.

[Opportunistic invasive mycoses in AIDS. An autopsy study of 211 cases.]. / Micosis oportunistas invasivas en el sida. Un estudio de 211 autopsias.

The opportunistic mycoses are an important cause of morbidity-mortality among patients with severe immunosuppression provoked by HIV. We present a study of 211 serial autopsies of patients with HIV/AIDS infection carried out by our service in a period of 10 years, observing frequency of invasive mycoses of the 44.1%. Pneumocystis carinii infection was the most frequent (32%) with a prevalence of lung affection. Candidiasis follows it in order of frequency with 31.1%, predominantly the oropharyngeal manifestation. Systemic or cerebromeningeal cryptococcosis were serious and common disorder (29%). Diseminated histoplasmosis occurred in 9.6% and in three cases (3.2%) pulmonary aspergillosis was diagnosed as a postmortem discovery in cavity lesions. In our series, other less common HIV-associated were not identified.

Evaluation of the antimeningococcal immunoglobin activity against five strains of Neisseria meningitidis group B from Latin America using mice as model.

To know the activity of antimeningococcal immunoglobulin, Balb/c mice of 18-22 g of body weight were challenged with 5 serotype B strains of Neisseria meningitidis (Nm) isolated from patients of different Latin American countries. The specific antimeningococcal Ig was extracted from the serum of volunteers previously vaccinated with the antimeningococcal BC vaccine VA-MENGOC-BC (Finlay Institute, Havana, Cuba). The Ig was intraperitoneally (IP) administered in a unique dose of 10 mg/mouse. The strains A, B, C, CH and D were inoculated IP in the following charges: strain A, 20 LD50; B, 25 LD50; C, 44.5 LD50; CH, 36 LD50, and D, 200, 20 and 2 LD50. For each strain, a control group received living bacteria and virulent stimulating factor (VSF). The Ig was injected 30 min before or 30 min after the challenge dose had been given, except for strain D, which only received the Ig 30 min after the challenge. As VSF, 0.5 mg of iron in the form of iron dextran was used. The experiment was analyzed considering the survival time after the challenge for each strain compared to the corresponding control group (C). When the Ig was used 30 min before the challenge, the protection period for the A strain was (C:18.1h) more than 72h (P<0.001) and 100% survival; for the B strain, (C:29.5h) 42h (P<0.05) and almost 20% survival; for the C strain (C:16.5h) 35h (P<0.01) with a 40% survival, and the CH strain (C:18.1h) 26.5h (P<0.02), with a 20% survival. When the Ig was injected 30 min after the challenge, the average survival time and the survival for the A strain was 28h (P<0.05) with 62.5%; for the B strain it was 42 h (P<0.005) and 0.0%; for the C strain 27.3 h (P<0.05) and 30%; for the CH strain 25.8h (P<0.05) and 0.0%, and for the D strain 19.1h, 26h, and more than 72h with a 0.0%, 60% and 100%, depending on the challenging dose. In general, the specific Ig used showed a protective effect in mice against the different Latin American strains tested. Additionally, the experimental model proved to be useful for the study of the antimeningococcal human Ig.

[Craniofacial dysmorphism in pediatric AIDS. Presentation of a case]. / Dismorfismo cráneo-facial en el SIDA pediátrico. Presentación de un caso.

The case of a five-year-old mulatto girl with craniofacial dysmorphism, infected with AIDS virus, is presented. The girl had ocular hypertelorism; eyes slanted upwards; increase of the distance between the internal and external canthi; prominent triangular philtrum; thick lips; prominent forehead; flat nasal bridge; large parotid glands, which indicate that the infection must have transmitted during fetal life. These features were not observed in children infected with AIDS through other ways such as perinatal transmission, blood transfusions and breastfeeding.

[Report pf the first case of lymphogranuloma venereum (LGV) in an HIV seropositive patient in Cuba]. / Reporte del primer caso de linfogranuloma venéreo (LGV) en un paciente seropositivo para VIH en Cuba.

The most important clinical and epidemiological aspects of the lymphogranuloma venereum as a sexually-transmitted disease are described. We present a summary of the clinical history of an HIV-positive patient who presented with a tumoral lesion in the inguinal region presumptive of lymphogranuloma venereum. The diagnostic value of the polymerase chain reaction (PCR) technique for the establishment of an accurate diagnosis is stressed the epidemiological importance of the report of this sexually-transmitted disease in an HIV-positive patient for the first time in Cuba is also pointed out. A good response was attained with Doxycycline.

[Pediatric AIDS: a report of the first fatal Cuban pediatric case]. / SIDA pediátrico: descripción del primer caso infantil cubano fallecido.

The case of a Cuban child with AIDS acquired by perinatal transmission is reported. Thirteen days after birth, the child had chronic diarrhoeas affecting its pondostatural development. It was hospitalized many times due to recurrent respiratory processes, in one of which Pneumocystis carinii was detected. Oral candidiasis, cryptosporidiosis and intestinal amebiasis in faeces were also diagnosed. It died with generalized tonic-clonic convulsions and bradypnea. At autopsy, the direct death cause was endocranial hypertension due to unspecific sub-acute viral meningitis.