Intra-abdominal fetus in fetu presenting at 31 weeks gestational age.

Fetus in fetu (FIF) is a rare anomaly of diamniotic monochorionic twins, in which a malformed fetus resides in its twin's body. This report shows a case with the prenatal diagnosis of FIF at Tu Du hospital. A 23-year-old woman, first-time pregnant, presented at the hospital with an abdominal mass in the fetus at 31 weeks and 4 days of gestation. The ultrasound showed an abnormal mass with the images of calcified features located in the left hypochondriac region and the kidney's upper pole. These images had shapes of skull, femur, spine and became more apparent as the fetus grew. Then, the patient was monitored and delivered at our hospital. The infant was moved to the Children's Hospital 1 and diagnosed with FIF by ultrasound. The surgical resection was performed at 12 days of birth.

[Penicillium marneffei infection and AIDS. A review of 12 cases reported in the Tropical Diseases Centre, Ho Chi Minh City (Vietnam)]. / Pénicilliose et sida : à propos de 12 cas diagnostiqués au Centre des maladies tropicales, Ho Chi Minh-ville (Vietnam).

Penicillium marneffei is a thermal dimorphic fungus which is endemic in an ecologic niche restricted to the Far East and which may cause deep-seated infection in humans and rodents. Discovered in the late 1950s from the bamboo rat Rhizomys sinensis, in Vietnam, P. marneffei was initially identified in HIV-infected individuals. A disseminated and progressive infection, it is the third most common opportunistic morbidity in the late course of HIV infection. We report the clinical and therapeutic features of a series of 12 HIV-infected adults with disseminated P. marneffei infection in Vietnam. From May to September, 2001, 12 patients with P. marneffei infection confirmed by culture were identified among 273 HIV-infected patients studied at the Tropical Diseases Centre, Ho Chi Minh City, Vietnam. The clinical signs were related to the reticuloendothelial system involvement. Common clinical features included fever, cutaneous manifestations, lymphadenopathy, hepatomegaly, splenomegaly, and marked anemia. The organism was identified from skin specimens or blood culture. Cases were consistently found with low CD4 (+) cell count. Treatment with parenteral amphotericin B and itraconazole was relatively effective, although treatment with a delaying diagnosis remained associated with pejorative prognosis.

[Cryptococosis and HIV/AIDS: a review of 21 cases reported in the Tropical Diseases Centre, Ho Chi Minh City (Vietnam)]. / Méningite à Cryptococcus neoformans chez les patients infectés par le VIH/sida dans le contexte du Centre des maladies tropicales, Ho Chi Minh-ville (Vietnam).

Cryptococcus neoformans affections during HIV-infection are frequent and serious. The aim of this study was to analyse the epidemiological, clinical, biological and therapeutic characteristics of cryptococcal meningitis in HIV-positive patients, admitted into the Center for Tropical Diseases Ho Chi Minh City (Vietnam), during a 5-month period (May-September 2001). Twenty-one patients (20 men and one woman) were included (identification of C. neoformans from the cerebrospinal fluid). The mean age was 28 years. The majority of patients had been living in Ho Chi Minh City (48%). The use of drugs and unprotected sexual relations were the principal risk factors of HIV-infection. The paucity and the confusion of clinical signs and symptoms, along with a high frequency of meningitis have been analysed. Clinical presentation features included: headache (95%), emaciation (90%), oro-pharyngeal candidiasis (90%), stiff neck (80%), nausea/vomiting (70%), fever (67%), coughing (38%), diarrhoea (33%), skin lesions (5%), convulsion (5%), photophobia (5%), and hemiparesis (5%). The severity of the prognosis was mainly linked to the delay before hospitalization, to the possible association with other opportunistic infections, and to the availability of appropriate treatment.

Co-infections HIV and microbacteriums causing hepatitis

Study 120 intravenous drug users admitted liver disease clinic and HIV clinic from April to July 2002, the results showed that reasons of 14.2% were routine examinations, the rest were fever, HIV-related conditions or symptoms of liver diseases or gastrointestinal diseases. 57% patients had transaminase level of >100 IU/l. Severe hepatocellular necrosis was remarkable in patients went to liver disease clinic. Important co-infection in 54 patients went to liver disease clinic was HIV-HBV-HVC. Intravenous drug users can be co-infected with many different viruses with severe hepatocellular necrosis, so they need appropriate treatments