Okuläre Syphilis kann zu bleibender Seheinschränkung führen

2019 ◽  
Vol 236 (04) ◽  
pp. 516-522
Author(s):  
Timothy Hamann ◽  
Mayss Al-Sheikh ◽  
Sandrine Zweifel ◽  
Fabio Meier ◽  
Daniel Barthelmes ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antibiotische Therapie ◽  
Sich Eine ◽  
Oder Eine ◽  
Fand Sich ◽  
Immunodeficiency Virus ◽  
Okuläre Syphilis ◽  
Posteriore Uveitis ◽  
Intraokulare Entzündung

Zusammenfassung Zweck Bei Patienten mit okulärer Syphilis wurde das Spektrum der intraokulären und der systemischen Befunde beschrieben. Es wurde analysiert, wie häufig persistierende Seheinschränkungen trotz Therapie auftraten und welches morphologische Korrelat den visuellen Dysfunktionen zugrunde lag. Methoden Eingeschlossen wurden Patienten, die zwischen 2010 und 2018 mit okulärer Syphilis im UniversitätsSpital Zürich behandelt wurden. Allgemeine Charakteristika, okuläre Präsentation, visuelle Funktionen (bestkorrigierter Visus, Gesichtsfeld) vor und nach Therapie wurden retrospektiv analysiert. Ergebnisse Bei 17 Patienten (1 weiblich, 16 männlich) mit einem medianen Alter von 42 Jahren (Spannweite 22 – 53), wurde eine okuläre Syphilis diagnostiziert. In 11 Fällen zeigte sich eine bilaterale Entzündung, es waren 28 von 34 Augen betroffen (82%). Anteriore (n = 3), intermediäre (n = 4), posteriore Uveitis (n = 10), Panuveitis (n = 5) und Papillitis (n = 6) lagen vor. Bei 8 Patienten fand sich ein abnormaler Liquorbefund (47%). Sechs von 17 Patienten (35%) waren HIV-positiv (HIV: human immunodeficiency virus). Bei allen Patienten sprach die intraokuläre Entzündung auf die intravenöse antibiotische Therapie mit Benzylpenicillin an. Die initiale Sehschärfe aller betroffenen Augen (n = 28) lag im Median bei 0,1 logMAR (0,8 dezimal), Spannweite 2,8 bis − 0,1 logMAR (Lichtperzeption bis 1,25 dezimal). Im letzten Follow-up lag die mediane Sehschärfe bei 0 logMAR, Spannweite 0,4 bis − 0,1 logMAR (0,4 – 1,25 dezimal). Die mediane Follow-up-Dauer lag bei 11 Monaten (Spannweite 3 – 60 Monate). Bei 4 Augen von 3 Patienten wurde beim letzten Follow-up ein korrigierter Visus von ≤ 0,6 erreicht. Sechs Augen von 5 Patienten zeigten ein persistierendes Skotom mit zentralen Gesichtsfelddefekten. Als morphologisches Korrelat der persistierenden Sehdysfunktionen fanden sich Alteration und Desintegration der äußeren Netzhautschichten und/oder eine Atrophie der peripapillären Nervenfaserschicht in Patienten, in denen sich die syphilitische Uveitis als Panuveitis mit Retinitis (n = 3 Augen), als posteriore Uveitis (n = 2 Augen) oder als Papillitis (n = 4 Augen) manifestierte. Schlussfolgerungen Das Spektrum der Manifestationen bei okulärer Syphilis ist breit. Trotz Therapie führte die okuläre Syphilis in über einem Drittel der betroffenen Augen zu persistierenden visuellen Einschränkungen. Besonders Patienten mit Retinitis oder Papillitis hatten ein Risiko für bleibende visuelle Dysfunktionen.

scholarly journals Highly Productive Infection with Pseudotyped Human Immunodeficiency Virus Type 1 (HIV-1) Indicates No Intracellular Restrictions to HIV-1 Replication in Primary Human Astrocytes

2001 ◽  
Vol 75 (17) ◽  
pp. 7925-7933 ◽  
Author(s):  
Mario Canki ◽  
Janice Ngee Foong Thai ◽  
Wei Chao ◽  
Anuja Ghorpade ◽  
Mary Jane Potash ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Human Immunodeficiency Virus Type ◽  
Productive Infection ◽  
Human Astrocytes ◽  
Immunodeficiency Virus ◽  
Infected Cells ◽  
Virus Expression ◽  
Hiv 1

ABSTRACT Human astrocytes can be infected with human immunodeficiency virus type 1 (HIV-1) in vitro and in vivo, but, in contrast to T lymphocytes and macrophages, virus expression is inefficient. To investigate the HIV-1 life cycle in human fetal astrocytes, we infected cells with HIV-1 pseudotyped with envelope glycoproteins of either amphotropic murine leukemia virus or vesicular stomatitis virus. Infection by both pseudotypes was productive and long lasting and reached a peak of 68% infected cells and 1.7 μg of viral p24 per ml of culture supernatant 7 days after virus inoculation and then continued with gradually declining levels of virus expression through 7 weeks of follow-up. This contrasted with less than 0.1% HIV-1 antigen-positive cells and 400 pg of extracellular p24 per ml at the peak of astrocyte infection with native HIV-1. Cell viability and growth kinetics were similar in infected and control cells. Northern blot analysis revealed the presence of major HIV-1 RNA species of 9, 4, and 2 kb in astrocytes exposed to pseudotyped (but not wild-type) HIV-1 at 2, 14, and 28 days after infection. Consistent with productive infection, the 9- and 4-kb viral transcripts in astrocytes infected by pseudotyped HIV-1 were as abundant as the 2-kb mRNA during 4 weeks of follow-up, and both structural and regulatory viral proteins were detected in infected cells by immunoblotting or cell staining. The progeny virus released by these cells was infectious. These results indicate that the major barrier to HIV-1 infection of primary astrocytes is at virus entry and that astrocytes have no intrinsic intracellular restriction to efficient HIV-1 replication.

scholarly journals Hepatitis B or Hepatitis C Virus Infection Is a Risk Factor for Severe Hepatic Cytolysis after Initiation of a Protease Inhibitor-Containing Antiretroviral Regimen in Human Immunodeficiency Virus-Infected Patients

2000 ◽  
Vol 44 (12) ◽  
pp. 3451-3455 ◽  
Author(s):  
Marianne Savès ◽  
François Raffi ◽  
Philippe Clevenbergh ◽  
Bruno Marchou ◽  
Anne Waldner-Combernoux ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Virus Surface ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Hepatic Cytolysis

ABSTRACT In a cohort of 1,047 human immunodeficiency virus type 1-infected patients started on protease inhibitors (PIs), the incidence of severe hepatic cytolysis (alanine aminotransferase concentration five times or more above the upper limit of the normal level ≥ 5N) was 5% patient-years after a mean follow-up of 5 months. Only positivity for hepatitis C virus antibodies (hazard ratio [HR], 7.95;P < 10−3) or hepatitis B virus surface antigen (HR, 6.67; P < 10−3) was associated with severe cytolysis. Before starting patients on PIs, assessment of liver enzyme levels and viral coinfections is necessary.

scholarly journals Nontyphi Salmonella Empyema with Bronchopleural Fistula in a Patient with Human Immunodeficiency Virus

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Douglas Bretzing ◽  
Tasnim Lat ◽  
Andrew Shakespeare ◽  
Mary Lee ◽  
Salim Surani ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Bronchopleural Fistula ◽  
Fibrinolytic Therapy ◽  
Watery Diarrhea ◽  
Increased Risk ◽  
Pulmonary Manifestations ◽  
Immunodeficiency Virus ◽  
Night Sweats ◽  
The Right

Patients with human immunodeficiency virus (HIV) have an increased risk of inoculation with nontyphoid Salmonella compared to the general population. While nontyphoid Salmonella commonly manifests as gastroenteritis, Salmonella bacteremia can be seen in patients with HIV. We present a case of disseminated Salmonellosis in a patient with HIV complicated by bronchopleural fistula and secondary empyema. Case Presentation. A 40-year-old African American male with HIV noncompliant with HAART therapy presented with complaints of generalized weakness, weight loss, cough, night sweats, and nonbloody, watery diarrhea of four weeks’ duration. A computed tomography (CT) scan demonstrated a bilobed large, thick-walled cavitary lesion in the right upper lobe communicating with the pleural space to form a bronchopleural fistula. Thoracentesis yielded growth of nontyphi Salmonella species consistent with empyema; he was treated with intravenous Ceftriaxone and underwent placement of chest tube for drainage of empyema with instillation of alteplase/dornase twice daily for three days. Repeat CT chest showed a hydropneumothorax. The patient subsequently underwent video-assisted thoracoscopy with decortication. The patient continued to improve and follow-up CT chest demonstrated improved loculated right pneumothorax with resolution of the right bronchopleural fistula and resolution of the cavitary lesions. Discussion. We describe one of the few cases of development of bronchopulmonary fistula and the formation of empyema in the setting of disseminated Salmonella. Empyema complicated by bronchopulmonary fistula likely led to failure of intrapleural fibrinolytic therapy and the patient ultimately required decortication in addition to antibiotics. While Salmonella bacteremia can be seen in immunocompromised patients, extraintestinal manifestations of Salmonella infection such as empyema and bronchopleural fistulas are uncommon. Bronchopleural fistulas most commonly occur as a postoperative complication of pulmonary resection. Conclusions. This case highlights the unusual pulmonary manifestations that can occur due to disseminated Salmonella in an immunocompromised patient as well as complex management decisions related to these complications.

scholarly journals Early Detection of Human Immunodeficiency Virus Type 1-Specific B-Lymphocyte-Derived Antibodies in a High-Risk Population

2009 ◽  
Vol 16 (7) ◽  
pp. 1060-1065 ◽  
Author(s):  
Odd Odinsen ◽  
David Parker ◽  
Frans Radebe ◽  
Mikey Guness ◽  
David A Lewis
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
B Cell ◽  
Immunodeficiency Virus ◽  
Hiv Antibodies ◽  
P24 Antigen ◽  
Anti Hiv ◽  
Hiv 1

ABSTRACT Diagnosis of acute human immunodeficiency virus (HIV) infection, a key driver of the HIV epidemic, remains a public health challenge. The PlasmAcute technology offers an opportunity to detect early anti-HIV antibody responses. B lymphocytes (B cells) were isolated from the blood of seronegative miners in South Africa by using the PlasmAcute method. B-cell lysates and paired sera were tested for anti-HIV-1 antibodies by two different enzyme-linked immunosorbent assays; immunoreactivity was confirmed by Western blotting. All volunteers were tested for HIV type 1 (HIV-1) viral load, p24 antigen, and CD4 count. Sera from HIV-seronegative men who had positive viral loads and were positive for p24 antigen were retested for anti-HIV antibodies after immune complex dissociation. Anti-HIV antibodies were detected in lysates from 16/259 subjects without immunoreactivity in paired sera. Four subjects, one of whom had a positive viral load initially, subsequently seroconverted. Six subjects showed transient anti-HIV-1 antibodies in the lysates and tested negative for all markers at the follow-up. Five subjects without follow-up data initially had lysate-positive/serum-negative samples, and these cases were classified as inconclusive. One subject had lysate antibodies and a detectable viral load but was seronegative at follow-up. In conclusion, lysate-derived anti-HIV-1 B-cell antibodies can be detected prior to seroconversion and earlier than or contemporary with HIV-1 RNA detection.

Fibro-osseous Pseudotumor of the Distal Phalanx

2021 ◽  
Vol 111 (5) ◽  
Author(s):  
Antonio Jesús Zalacain-Vicuña ◽  
Elena de Planell-Mas ◽  
Nuria Espada-Martín ◽  
Laura Planas-Ortega ◽  
Maria Elena Subero-Tomás
Keyword(s):  
Human Immunodeficiency Virus ◽  
Benign Tumor ◽  
Distal Phalanx ◽  
Immunodeficiency Virus

Fibro-osseous pseudotumor of the digit is an unusual benign tumor that appears on the extremities. A 45-year-old, human immunodeficiency virus–positive man presented with a painful lesion on the tip of the fourth toe of his right foot. The tumor was completely excised without any connection to the underlying bone being observed, although the phalanx had to be extirpated. Histopathology confirmed the diagnosis of fibro-osseous pseudotumor. At the follow-up visit, 12 months later, no abnormalities were found.

Sign in / Sign up

Export Citation Format

Share Document