ABSTRACT
Three children with acquired immunodeficiency syndrome who had pneumonia develop were infected simultaneously with Pneumocystis carinïi and Streptococcus pneumoniae. Such coexistence has not been previously reported in children. One patient received prophylactic treatment against Pneumocystis carinïi before his illness.
Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Pneumonia, Pneumococcal/complications , Pneumonia, Pneumocystis/complications , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
To ascertain the effect of cytomegalovirus (CMV) infection on the course of Pneumocystis carinii pneumonia (PCP) in children with acquired immunodeficiency syndrome (AIDS), we reviewed the charts of all children with AIDS who also had a lung biopsy specimen or a bronchoalveolar lavage specimen cultured for CMV at the time PCP was diagnosed. The data indicate that children with AIDS and PCP whose cultures are positive for CMV do not have a poorer prognosis during a first episode of PCP compared with children whose cultures are negative for CMV.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Cytomegalovirus Infections/complications , Opportunistic Infections/complications , Pneumonia, Pneumocystis/complications , Bronchoalveolar Lavage Fluid/microbiology , Child, Preschool , Cytomegalovirus Infections/mortality , Humans , Infant , Lung/microbiology , Opportunistic Infections/mortality , Pneumonia, Pneumocystis/mortality , Prognosis , Retrospective StudiesSubject(s)
Bile Ducts/abnormalities , Cholestasis, Extrahepatic/etiology , Diseases in Twins , Twins, Monozygotic , Twins , Cholestasis, Extrahepatic/diagnosis , Cholestasis, Extrahepatic/genetics , Female , Humans , Infant , Pregnancy , Reoviridae Infections/complications , Reoviridae Infections/diagnosis , Serologic TestsABSTRACT
Two patients are described with meningitis caused by multiply antibiotic-resistant strains of viridans streptococci; both isolates were resistant to penicillin (MIC greater than 3 micrograms/ml) (4.8 U/ml) and to several other antimicrobial agents. Our findings underscore the importance of doing in vitro sensitivity testing with clinical isolates of viridans streptococci to determine appropriate therapy for infected patients. Multiply antibiotic-resistant strains of viridans streptococci have also been recently isolated in the same populations in South Africa in which the prevalence of resistant Streptococcus pneumoniae is high. Therefore, isolation of resistant clinical strains of viridans streptococci may suggest the need for in vitro surveillance of emerging antibiotic resistance in both streptococcal species.
Subject(s)
Meningitis/etiology , Streptococcal Infections , Anti-Bacterial Agents/therapeutic use , Child, Preschool , Drug Resistance, Microbial , Female , Humans , Infant, Newborn , Male , Meningitis/drug therapy , Penicillin Resistance , Streptococcal Infections/drug therapyABSTRACT
The relationship between reovirus type 3 and persistent infantile cholestasis was studied by measuring antibody to the virus in the sera of affected and control babies younger than 1 year of age. One hundred sixty-seven infants were divided into four groups: those with extrahepatic biliary atresia, idiopathic neonatal hepatitis, or other cholestatic disorders, and controls. When available, maternal sera obtained simultaneously with infant sera were also studied. The results indicate that 62% of babies with extrahepatic biliary atresia and 52% of infants with idiopathic neonatal hepatitis have reovirus 3 antibodies. In contrast, less than 12% of either normal infants or babies with other cholestatic disorders have antibodies. These observations suggest that perinatal infection with reovirus type 3 may serve as an initiating event in the genesis of two closely related forms of infantile obstructive cholangiopathy: extrahepatic biliary atresia and idiopathic neonatal hepatitis.