Subject(s)
Humans , Male , Middle Aged , Osteomyelitis/complications , Osteomyelitis/diagnosis , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/pathogenicity , Klebsiella Infections/complications , Liver Cirrhosis/complications , Liver Cirrhosis/diagnosis , Osteomyelitis/drug therapy , Osteomyelitis/physiopathology , Osteomyelitis , Liver Cirrhosis/therapySubject(s)
Bacteremia/mortality , Pneumococcal Infections/mortality , Pneumococcal Vaccines/administration & dosage , Adolescent , Adult , Aged , Bacteremia/microbiology , Centers for Disease Control and Prevention, U.S. , Female , Humans , Male , Middle Aged , Pneumococcal Infections/prevention & control , Pneumonia, Pneumococcal/mortality , Practice Guidelines as Topic , Prognosis , United Kingdom , United StatesABSTRACT
La paquimeningitis crónica hipertrófica idiopática (PCHI) es un raro desorden caracterizado por inflamación crónica de la duramadre que puede asociarse a déficits neurológicos resultantes de la compresión de estructuras subyacentes. La etiología del proceso es incierta y para su diagnóstico es preciso descartar patología infecciosa, enfermedades del sistema inmune y otros procesos, junto con la confirmación anatomopatológica de la existencia de un infiltrado inflamatorio crónico de la duramadre, estéril sin evidencia de fenómenos vasculíticos o malignidad. La PCHI es una entidad poco frecuente. Revisando Medline de los últimos 35 años hemos encontrado 58 casos de PCHI, de los cuales en 43 la afectación estaba localizada a nivel intracraneal, siendo ésta la localización más frecuente, seguida de 11 casos donde la afectación estaba localizada a nivel espinal y 4 a nivel craneoespinal. Presentamos dos casos clínicos de PCHI de localización espinal, uno a nivel dorsal y otro lumbar vistos en nuestro servicio. Revisamos las manifestaciones clínicas, métodos diagnósticos y actitud terapéutica de los casos encontrados en la literatura (AU)
Subject(s)
Middle Aged , Adult , Male , Female , Humans , Meningitis , Chronic Disease , Dura Mater , Magnetic Resonance Imaging , HypertrophyABSTRACT
The idiopathic hypertrophic chronic pachymeningitis (IHCP) is a rare disorder characterized by chronic inflammation of the dura mater that there can be associated with resulting neurological deficits from the compression of underlying structures. The etiology of the pathologic process is uncertain and for its diagnosis it is necessary to rule out infectious pathology, diseases of the immune system and other processes, together with the pathological confirmation of the existence of a steril and chronic inflammatory infiltrate of the dura mater, and without evidence of vasculitic sings or malignancy. The IHCP is an infrequent entity. Through Medline last 35 years review we have found 58 cases of IHCP, of which in 43 the affectation was located at intracranial level, being this the most frequent localization, followed by 11 cases where the affectation was located at spinal level and 4 at craniospinal level. We present two clinical cases of IHCP of spinal localization, one at dorsal level and another one at the lumbar level seen in our institution, and we review the clinical manifestations, diagnostic methods, and therapeutic attitude used in the cases found in the literature.
Subject(s)
Dura Mater/pathology , Meningitis/pathology , Adult , Chronic Disease , Female , Humans , Hypertrophy/complications , Hypertrophy/diagnostic imaging , Magnetic Resonance Imaging , Male , Meningitis/diagnostic imaging , Meningitis/therapy , Middle Aged , RadiographyABSTRACT
No disponible
Subject(s)
Middle Aged , Adult , Adolescent , Aged , Male , Female , Humans , United States , Bacteremia , Practice Guidelines as Topic , Pneumococcal Infections , Pneumonia, Pneumococcal , Prognosis , Pneumococcal Vaccines , United Kingdom , Centers for Disease Control and Prevention, U.S.Subject(s)
Abscess/diagnosis , Hip Joint/diagnostic imaging , Mycobacterium tuberculosis/isolation & purification , Thigh/microbiology , Tuberculosis, Osteoarticular/diagnosis , Abscess/microbiology , Abscess/therapy , Antitubercular Agents/therapeutic use , Diagnosis, Differential , Hip Joint/microbiology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Orthopedic Procedures/methods , Radiography , Soft Tissue Neoplasms/diagnosis , Thigh/diagnostic imaging , Thigh/pathology , Treatment Outcome , Tuberculosis, Osteoarticular/microbiologyABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Thigh , Tuberculosis, Osteoarticular , Orthopedic Procedures , Treatment Outcome , Mycobacterium tuberculosis , Antitubercular Agents , Diagnosis, Differential , Abscess , Magnetic Resonance Imaging , Hip Joint , Soft Tissue NeoplasmsSubject(s)
Lymphoma, Large B-Cell, Diffuse/diagnosis , Splenic Neoplasms/diagnosis , Female , Humans , Middle AgedABSTRACT
No disponible
Subject(s)
Middle Aged , Female , Humans , Splenic Neoplasms , Lymphoma, Large B-Cell, DiffuseABSTRACT
The acute respiratory distress syndrome (ARDS) is a rare but serious complication of miliary tuberculosis with a mortality rate near 100% when associated with pancytopenia. This association has been rarely reported (eleven cases in a Medline search, 1966-1999). A case is here reported of an HIV-negative patient with miliary tuberculosis which presented as ARDS associated with pancytopenia. This case prompted us to review the literature and risk factors, diagnosis and treatment issues are discussed. In patients with predisposing factors miliary tuberculosis must be considered as a possible cause of ARDS.
Subject(s)
HIV Seronegativity , Pancytopenia/complications , Respiratory Distress Syndrome/complications , Tuberculosis, Miliary/complications , Adolescent , Humans , MaleABSTRACT
El síndrome de distrés respiratorio agudo (SDRA) es una complicación rara pero muy grave de la tuberculosis miliar que cuando se asocia a pancitopenia se acerca a una mortalidad del 100 por ciento. Esta asociación ha sido escasamente descrita (11 casos en revisión Medline, 1966-1999).Presentamos el caso de 1 paciente VIH negativo con una tuberculosis miliar que comienza como un SDRA, al que se asocia pancitopenia. A propósito del mismo se revisa la literatura, describiéndose los factores de riesgo, diagnóstico y tratamiento. Es fundamental considerar la tuberculosis como etiología posible en pacientes con factores de riesgo que presentan SDRA (AU)
No disponible
Subject(s)
Adolescent , Male , Humans , HIV Seronegativity , Tuberculosis, Miliary , Pancytopenia , Respiratory Distress SyndromeSubject(s)
Capnocytophaga , Gram-Negative Bacterial Infections , Animals , Bites and Stings/complications , Capnocytophaga/classification , Capnocytophaga/isolation & purification , Classification , Dogs , Female , Gram-Negative Bacterial Infections/etiology , Gram-Negative Bacterial Infections/microbiology , Humans , Middle AgedABSTRACT
BACKGROUND: Bacteremic infection with Pseudomonas aeruginosa is an uncommon and late phenomenon in the natural history of infection with human immunodeficiency virus (HIV). Our objective was to study the clinico-epidemiological characteristics of P. aeruginosa bacteremia (PAB) in patients infected with HIV. PATIENTS AND METHODS: A retrospective study of 17 episodes of PAB in 16 patients infected with HIV in three tertiary hospitals in the Valencia Community. Data were collected by means of a protocol designed to obtain clinical and epidemiological information. RESULTS: Fourteen out of 16 HIV-positive patients with PAB were males and in nine patients the risk factor for the acquisition of HIV was parenteral drug abuse. Eighty-one percent (13 patients) met diagnostic criteria for AIDS. Fourteen patients had less than 100 CD4 lymphocytes/mm3 at diagnosis of bacteremia (mean value 25.8). PAB was acquired in the community in 13 episodes (76.4%). Nine patients (56.2%) had received some type of antimicrobial therapy during the last month, 12 (75%) were taking anti-retroviral therapy, and 6 (37.5%) were receiving prophylaxis against P. carinii. The most frequent source for PAB was pneumonia with 7 episodes (41.2%), followed by the intravascular catheter infection with 2 (12%). In six episodes (35.3%) no source was identified. Only one episode was evaluated as recurrence. Only two of the seven patients with pneumonia had pulmonary cavitation in the chest X-ray. Fifteen episodes resolved (94%) and in only one case was dead directly related to PAB. CONCLUSIONS: In our experience, PAB in patients infected with HIV emerges in the advanced stages of disease. The most common source was the lower respiratory tract and in most cases PAB was acquired in the community. The mortality rate resulting from PAB was lower than that previously reported in the literature.
Subject(s)
Bacteremia/epidemiology , HIV Infections/complications , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa , Adult , Aged , Bacteremia/microbiology , Female , Humans , Male , Middle Aged , Morbidity , Pseudomonas Infections/microbiology , Retrospective Studies , Risk FactorsABSTRACT
Two cases are reported of hepatic tuberculous abscesses (HTBA) in patients infected with the human immunodeficiency virus (HIV), stressing the rarity of this location. Likewise, a review is made of cases reported in the literature. Our two patients presented with a prolonged febrile condition, with constitutional symptoms and nonspecific abdominal discomfort. In one patient the hepatic location was accompanied by a pulmonar location too. The course of the patients was good and symptoms subsided with tuberculostatic therapy. To note the possibility of finding hepatic tuberculous abscesses in HIV patients with prolonged fever and nonspecific abdominal pain more frequently than considered until now.
Subject(s)
HIV Infections/complications , Liver Abscess/complications , Tuberculosis, Hepatic/complications , Adult , Humans , MaleABSTRACT
We present a prospective follow-up study of 114 patient infected by Candida and HIV, in order to assess the role of oral candidiasis (OC) as a predictive marker of tuberculosis and opportunistic infections (OI) which define the Acquired Immunodeficiency Syndrome (AIDS). We compared the study group with an homogeneous control group of 152 patients infected by HIV without OC during the same period. TBC findings in the first group were discriminant with respect to the control group (p less than 0.0001) with and average period of 2.5 months between the diagnosis of OC and the development of TBC. These findings suggest that OC is an early evolutive marker of TBC and a late marker of AIDS.
Subject(s)
Candidiasis, Oral/complications , HIV Infections/complications , Opportunistic Infections/complications , Tuberculosis/complications , Adult , Female , Humans , Male , Prospective Studies , Tuberculosis/diagnosisABSTRACT
A HIV infected patient was admitted to hospital with fever diarrhoea and a cutaneous nodule on his left groin. Histopathological exam was diagnostic of cutaneous leishmaniasis. Subsequent exams disclosed Visceral Leishmaniasis. Three cycles of treatment (antimonials, pentamidine and metronidazole) were required for the clearance of lesions. The relation between immunosuppression and leishmania infection is commented and its role as an opportunistic pathogen is suggested. In these patients the infection takes a more aggressive course and has a worse response to the classic treatment with antimonials. These facts have made necessary the introduction of other alternative drugs.
