Gliosarcoma: an unusual cause of cerebral mass lesion in a patient with AIDS. A case report and review of the literature.

Malignant glioma is the most common primary brain neoplasm. Generally, gliomas are not included in the differential diagnosis of enhancing lesions of the central nervous system in patients infected by the human immunodeficiency virus. We report a case of gliosarcoma in a patient with AIDS presenting as a single cerebral lesion. Stereotactic brain biopsy was obtained and definitive histopathological diagnosis of gliosarcoma was made. A decline in the incidence of opportunistic infections associated with highly active antiretroviral therapy suggest the importance of early stereotactic biopsy to confirm the diagnosis of these neoplasms.

[Pulmonary cryptosporidiosis in AIDS patients]. / Criptosporidiosis broncopulmonar en pacientes infectados por el virus de la inmunodeficiencia humana.

Pulmonary cryptosporidiosis is a rare complication of intestinal cryptosporidiosis in AIDS patients. We report the epidemiological, clinical, radiological, microbiological and immunological findings in 5 AIDS patients with pulmonary cryptosporidiosis. Diagnosis was based on the detection of acid-fast oocysts in sputum or aspirated bronchial material using the Kinyoun technique. Microbiology laboratories should be alert to the possibility of Cryptosporidium spp oocysts presence in respiratory specimens from patients with advanced HIV/AIDS disease and pulmonary involvement.

Criptosporidiosis broncopulmonar en pacientes infectados por el virus de la inmunodeficiencia humana / Pulmonary cryptosporidiosis in AIDS patients

La criptosporidiosis pulmonar es una rara complicación de la enfermedad intestinal causada por este agente en pacientes con SIDA. En este trabajo se describen las características epidemiológicas, clínicas, radiológicas, microbiológicas e inmunológicas de 5 pacientes con SIDA y criptosporidiosis pulmonar. El diagnóstico de la localización pulmonar se basó en el hallazgo de ooquistes de Cryptosporidium spp. en muestras de esputo o lavado broncoalveolar utilizando la coloración de Kinyoun. Los laboratorios de microbiología deben estar alerta ante la posibilidad de identificar ooquistes de Cryptosporidium spp. en secreciones broncopulmonares de pacientes con enfermedad VIH/SIDA avanzada.

Pulmonary cryptosporidiosis is a rare complication of intestinal cryptosporidiosis in AIDS patients. We report the epidemiological, clinical, radiological, microbiological and immunological findings in 5 AIDS patients with pulmonary cryptosporidiosis. Diagnosis was based on the detection of acid-fast oocysts in sputum or aspirated bronchial material using the Kinyoun technique. Microbiology laboratories should be alert to the possibility of Cryptosporidium spp oocysts presence in respiratory specimens from patients with advanced HIV/AIDS disease and pulmonary involvement.

[Disseminated cryptococcosis in patients with AIDS. Clinical, microbiological, and immunological analysis of 51 patients]. / Criptococosis diseminada en pacientes con SIDA. Análisis clínico, microbiológico e inmunológico de 51 pacientes.

In the context of HIV infection, cryptococcal meningitis is the most common mycosis threatening the patient's life. We conducted a retrospective evaluation to determine the epidemiological, microbiological, immunological and clinical characteristics of disseminated cryptococcosis in 51 hospitalised HIV seropositive patients. All the individuals (n = 51) presented reactive serology for HIV (ELISA and/or Western blot) and none fulfilled strict HAART treatment, previous to the opportunistic infection. CD4+ lymphocyte T counts showed levels between 361 and 0 cells/microliter (mean = 45). All patients but one had counts lower than 100 cells/microliter. Cryptococcosis presented as unique episode in 35 patients (68.6%) and in 16 as relapse (31.3%). In all of them we detected central nervous system involvement. The induction treatment was carried out with amphotericin B (AMB), continued with maintenance therapy with fluconazole. Lethality rate was 36.7%, slightly superior among patients in relapse (40%) compared to those who presented a first episode of the mycosis (35.2%). In those individuals for whom data were available, 65.2% of blood cultures, 94.1% of CSF cultures and 79.06% of microscopic CSF examination with India ink were positive. Titers of Cryptococcus neoformans capsular antigen in CSF > or = 1/1000 were found in 36.1% and > or = 1/1000 in 73.6% of serum samples. In conclusion, manifestations and severity of disseminated cryptococcosis continue maintaining the characteristics of half a decade behind, in those patients who are not treated with HAART. Neurological involvement existed in all patients of this cohort. Treatment is not able to modify the parameters of mortality seen in previous communications. Diagnostic methods applied in this study are in accordance with those in the bibliography.

Criptococosis diseminada en pacientes con SIDA. Análisis clYnico, microbiológico e inmunológico de 51 pacientes / Disseminated cryptococcosis in patients with AIDS. Clinical, microbiological, and immunological analysis of 51 patients

In the context of HIV infection, cryptococcal meningitis is the most common mycosis threatening the patients life. We conducted a retrospective evaluation to determine the epidemiological, microbiological, immunological and clinical characteristics of disseminated cryptococcosis in 51 hospitalised HIV seropositive patients. All the individuals (n = 51) presented reactive serology for HIV (ELISA and/or Western blot) and none fulfilled strict HAART treatment, previous to the opportunistic infection. CD4+ lymphocyte T counts showed levels between 361 and 0 cells/microliter (mean = 45). All patients but one had counts lower than 100 cells/microliter. Cryptococcosis presented as unique episode in 35 patients (68.6) and in 16 as relapse (31.3). In all of them we detected central nervous system involvement. The induction treatment was carried out with amphotericin B (AMB), continued with maintenance therapy with fluconazole. Lethality rate was 36.7, slightly superior among patients in relapse (40) compared to those who presented a first episode of the mycosis (35.2). In those individuals for whom data were available, 65.2 of blood cultures, 94.1 of CSF cultures and 79.06 of microscopic CSF examination with India ink were positive. Titers of Cryptococcus neoformans capsular antigen in CSF > or = 1/1000 were found in 36.1 and > or = 1/1000 in 73.6 of serum samples. In conclusion, manifestations and severity of disseminated cryptococcosis continue maintaining the characteristics of half a decade behind, in those patients who are not treated with HAART. Neurological involvement existed in all patients of this cohort. Treatment is not able to modify the parameters of mortality seen in previous communications. Diagnostic methods applied in this study are in accordance with those in the bibliography.(AU)

Criptococosis diseminada en pacientes con SIDA. Análisis clÝnico, microbiológico e inmunológico de 51 pacientes / Disseminated cryptococcosis in patients with AIDS. Clinical, microbiological, and immunological analysis of 51 patients

In the context of HIV infection, cryptococcal meningitis is the most common mycosis threatening the patient's life. We conducted a retrospective evaluation to determine the epidemiological, microbiological, immunological and clinical characteristics of disseminated cryptococcosis in 51 hospitalised HIV seropositive patients. All the individuals (n = 51) presented reactive serology for HIV (ELISA and/or Western blot) and none fulfilled strict HAART treatment, previous to the opportunistic infection. CD4+ lymphocyte T counts showed levels between 361 and 0 cells/microliter (mean = 45). All patients but one had counts lower than 100 cells/microliter. Cryptococcosis presented as unique episode in 35 patients (68.6) and in 16 as relapse (31.3). In all of them we detected central nervous system involvement. The induction treatment was carried out with amphotericin B (AMB), continued with maintenance therapy with fluconazole. Lethality rate was 36.7, slightly superior among patients in relapse (40) compared to those who presented a first episode of the mycosis (35.2). In those individuals for whom data were available, 65.2 of blood cultures, 94.1 of CSF cultures and 79.06 of microscopic CSF examination with India ink were positive. Titers of Cryptococcus neoformans capsular antigen in CSF > or = 1/1000 were found in 36.1 and > or = 1/1000 in 73.6 of serum samples. In conclusion, manifestations and severity of disseminated cryptococcosis continue maintaining the characteristics of half a decade behind, in those patients who are not treated with HAART. Neurological involvement existed in all patients of this cohort. Treatment is not able to modify the parameters of mortality seen in previous communications. Diagnostic methods applied in this study are in accordance with those in the bibliography.

Criptococosis diseminada en pacientes con SIDA. Análisis clínico, microbiológico e inmunológico de 51 pacientes. / [Disseminated cryptococcosis in patients with AIDS. Clinical, microbiological, and immunological analysis of 51 patients]

In the context of HIV infection, cryptococcal meningitis is the most common mycosis threatening the patients life. We conducted a retrospective evaluation to determine the epidemiological, microbiological, immunological and clinical characteristics of disseminated cryptococcosis in 51 hospitalised HIV seropositive patients. All the individuals (n = 51) presented reactive serology for HIV (ELISA and/or Western blot) and none fulfilled strict HAART treatment, previous to the opportunistic infection. CD4+ lymphocyte T counts showed levels between 361 and 0 cells/microliter (mean = 45). All patients but one had counts lower than 100 cells/microliter. Cryptococcosis presented as unique episode in 35 patients (68.6

) and in 16 as relapse (31.3

). In all of them we detected central nervous system involvement. The induction treatment was carried out with amphotericin B (AMB), continued with maintenance therapy with fluconazole. Lethality rate was 36.7

, slightly superior among patients in relapse (40

) compared to those who presented a first episode of the mycosis (35.2

). In those individuals for whom data were available, 65.2

of blood cultures, 94.1

of CSF cultures and 79.06

of microscopic CSF examination with India ink were positive. Titers of Cryptococcus neoformans capsular antigen in CSF > or = 1/1000 were found in 36.1

and > or = 1/1000 in 73.6

of serum samples. In conclusion, manifestations and severity of disseminated cryptococcosis continue maintaining the characteristics of half a decade behind, in those patients who are not treated with HAART. Neurological involvement existed in all patients of this cohort. Treatment is not able to modify the parameters of mortality seen in previous communications. Diagnostic methods applied in this study are in accordance with those in the bibliography.

Estrogen receptors, progesterone receptors and heat-shock 27-kD protein in liver biopsy specimens from patients with hepatitis B virus infection.

It has been proposed that in the human liver, the estrogen receptor gene may become inappropriately expressed as a consequence of HBV integration, contributing to cell transformation. This study was undertaken to examine estrogen receptor status in patients with hepatitis B virus infection and to analyze the expression of progesterone receptor and of a heat-shock 27,000-D protein (hsp27), both of which are estrogen regulated in estrogen target tissues. Receptor proteins were detected in liver biopsy specimens by immunocytochemistry using antireceptor monoclonal antibodies; a monoclonal antibody was also used to detect hsp27. Estrogen receptor and progesterone receptor were mainly seen in the nuclei of hepatocytes. The presence of hepatitis B virus infection did not always result in elevated estrogen receptor expression, but in general the expression of this receptor protein was higher in hepatitis B virus-positive patients than in patients with the same pathological findings (hepatitis, cirrhosis, hepatocarcinoma) but without hepatitis B virus. This was more clearly seen in the patients with hepatitis. Although estrogen receptor expression was moderate to high in many samples, the expression of the two biochemical markers of estrogen action at postreceptor levels (progesterone receptor and hsp27) was low or absent in most of the liver tissues examined, suggesting that in the liver the interaction of estrogen-estrogen receptor-DNA has characteristics inherent to this tissue.