[Meningitis and brain abscess caused by Streptococcus intermedius in a patient infected with HIV-1]. / Meningitis y absceso cerebral por Streptococcus intermedius en un paciente con infección por VIH-1.

Streptococcus milleri group have been recognized as an important pathogens for abscess formation in various organs. Streptococci other than Streptococcus pneumoniae are a rare cause of bacterial meningitis in adults and can be associated with the presence of an undiagnosed brain abscess. Brain abscess is a focal collection within the brain parenchyma which can arise as a complication of a variety of infections. The most common etiologic organisms in clinical series have been microaerophilic streptococci and anaerobic bacteria. Although intracranial mass lesions that occur as a result of infection have commonly been reported in patients infected with the human immunodeficiency virus, brain abscess due to the common bacterial pathogens are rarely described in HIV infected patients and Toxoplasma gondii is the organism most frequently isolated from stereotactic brain biopsy in these patients. We report a patient with both HIV-1 infection and streptococcal meningitis secondary to brain abscess caused by S. intermedius.

Meningitis y absceso cerebral por Streptococcus intermedius en un paciente con infección por VIH-1 / Meningitis and brain abscess caused by streptpcoccus intermedius in a patient infected with HIV-1

Los estreptococos de grupo milleri se caracterizan por su tendencia a provocar infecciones piógenas invasoras en diferentes localizaciones. Las meningitis estreptocócicas no neumocócicas son poco frecuentes en pacientes adultos y pueden asociarse a la presencia de un absceso cerebral. Los abscesos cerebrales son colecciones localizadas dentro del parénquima cerebral que se originan como complicación de una infección, siendo los estreptococos microaerófilos y las bacterias anaerobiaslos microorganismos más frecuentemente aislados. Aunque no es inusual la presencia de colecciones intracraneales de etiología infecciosa en pacientes con infección por VIH-1, los abscesos cerebrales producidos por las bacterias piógenas habituales son muy infrecuentes y es T. gondiiel agente etiológico más frecuente. Aportamos un caso de meningitis y absceso cerebral por S. intermedius en un paciente con infección por VIH-1

Streptococcus milleri group have been recognized as an important pathogens for abscess formation in various organs. Streptococci other than Streptococcus pneumoniae are a rare cause of bacterial meningitis in adults and can be associated with the presence of an undiagnosed brain abscess. Brain abscess is a focal collection within the brain parenchyma wich can arise as a complication of a variety of infections. The most common etiologic organisms in clinical series have been microaerophilic streptococci and anaerobic bacterias. Although intracraneal mass lesions that occur as a result of infection have commonly been reported in patients infected with the human immunodeficiency virus, brain abscess due to the common bacterial pathogens are rarely described in HIV infected patients and Toxoplasma gondii is the organism most frecuently isolated from stereotactic brain biopsy in these patients. We report a patient with both HIV-1 infection and streptococcal meningitis secondary to brain abscess caused by S. intermedius

[Thrombotic thrombopenic purpura and HIV infection. Apropos of a case]. / Púrpura trombótica trombopénica e infección VIH. A propósito de un caso.

In the past years, more than thirty cases of thrombotic thrombocytopenic purpura (TTP) had been described associated to infection by the human immunodeficiency virus. Some authors have suggested the presence of a causal relationship between both entities, although the common nexus is still unknown. It usually has a fulminant onset, affecting all the risk groups and in any stage of the disease. The clinical manifestations are similar to the classical forms, as well as the evolution and response to treatment. We present a new clinical case, typical in its presentation and its good response to treatment with plasmatic spares associated to PFC and steroid infusion. We believe that the presence of clinical signs suggesting TTP in a patient would necessarily discard the presence of HIV infection and, the other way round, the presence of clinical signs suggesting TTP in a patient with HIV infection would determine the onset of an early and aggressive treatment based on plasmatic spares, given that the prognosis is linked to an early onset of the treatment.