A 33-Year-Old With Human Immunodeficiency Virus/AIDS and Multiple Skin Lesions

We report on a case of mixed infection caused by two species ofFusarium in a human immunodeficiency virus-positive patient with lymphoma who was neutropenic due to chemotherapy. The patient showed the typical signs of a disseminated fusarial infection, withFusarium solani isolated from skin lesions and F. verticillioides isolated from blood. The report discusses how difficult it is to make an accurate diagnosis when an immunosuppressed patient is infected with more than one fungal species, especially when the species are morphologically very similar.

Download Full-text

Blindness in a Woman With Human Immunodeficiency Virus Infection and Syphilis

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744995000615 ◽

1995 ◽

Vol 3 (5) ◽

pp. 198-201

Author(s):

Michael Luchi ◽

Curtis Beauregard ◽

Kevin Ault ◽

Daniel Hinthorn

Keyword(s):

Human Immunodeficiency Virus ◽

Cerebrospinal Fluid ◽

Virus Infection ◽

Hiv Infection ◽

Skin Lesions ◽

High Dose ◽

Progressive Loss ◽

Immunodeficiency Virus ◽

History Of ◽

Hands And Feet

Background: A concomitant infection with human immunodeficiency virus (HIV) may alter the natural history of other infections. Several reports indicate that syphilis may behave more aggressively when HIV infection is present.Case: A woman presented with a rash involving her hands and feet and progressive loss of the vision in her right eye. Her serologic tests for syphilis and HIV infection were positive. A diagnosis of neurosyphilis was confirmed by an analysis of cerebrospinal fluid (CSF). She was treated with high-dose intravenous (IV) penicillin. Her skin lesions resolved, but her vision did not improve.Conclusion: The incidence of HIV infection among women is rising. A patient with HIV and syphilis may develop neurosyphilis in a much shorter time than a patient without HIV infection.

Download Full-text

Primary syphilitic proctitis associated with human immunodeficiency virus infection in a male patient who had sex with men: a case report

10.31083/jomh.2021.086 ◽

2021 ◽

pp. 1-4

Keyword(s):

Human Immunodeficiency Virus ◽

Hiv Infection ◽

Male Patient ◽

Treponema Pallidum ◽

Skin Lesions ◽

Penicillin G ◽

Rectal Ulcer ◽

Viral Therapy ◽

Immunodeficiency Virus ◽

Sex With Men

Background: Men who have sex with men (MSM) have frequent rectal infections. Although a large increase in incidence of syphilis has been reported in recent years, rectal chancre is a rare manifestation that can easily be neglected. Methods: We describe a male patient who had sex with men and presented with protracted chronic proctitis and scaly rashes. A diagnosis of HIV infection and early syphilis with syphilitic proctitis (rectal chancre) was confirmed by the findings of ulcerative proctitis under colonoscopy, the presence of Treponema pallidum in rectal ulcer biopsy specimens by immunohistochemistry, and positive serologic test results for human immunodeficiency virus type 1 (HIV-1) and syphilis. Results: Intramuscular benzathine penicillin G (2.4 million Units) given once a week for three consecutive weeks resulted in complete resolution of rectal and skin lesions. The patient also began regular anti-viral therapy against HIV infection. Conclusion: Immunohistochemical detection of Treponema pallidum in the primary infection tissue is a useful complement to serologic tests for the diagnosis of syphilis by clinical laboratories. Healthy and protective sexual behavior is advocated to avoid possible infections in MSM.

Download Full-text

Indigenous Disseminated Penicillium marneffeiInfection in the State of Manipur, India: Report of Four Autochthonous Cases

Journal of Clinical Microbiology ◽

10.1128/jcm.37.8.2699-2702.1999 ◽

1999 ◽

Vol 37 (8) ◽

pp. 2699-2702 ◽

Cited By ~ 27

Author(s):

P. Narendra Singh ◽

K. Ranjana ◽

Y. Indiver Singh ◽

K. Priyokumar Singh ◽

S. Surchandra Sharma ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Fluorescent Antibody ◽

Skin Lesions ◽

Molluscum Contagiosum ◽

Eastern India ◽

Direct Examination ◽

Specific Diagnosis ◽

Immunodeficiency Virus ◽

First Occurrence ◽

Northeastern State

We describe four cases of disseminated infection caused by endemicPenicillium marneffei in human immunodeficiency virus (HIV)-infected patients from the Manipur state of India. The most common clinical features observed were fever, anorexia, weight loss, hepatosplenomegaly, and, more importantly, skin lesions resembling molluscum contagiosum. The diagnosis in each of the four cases was achieved by direct examination of smears, observance of intracellular yeast-like cells multiplying by fission in biopsied tissue from skin lesions, and isolation of the dimorphic P. marneffei in pure culture in each case. In one case, fluorescent antibody studies allowed specific diagnosis. This report documents a new area in whichP. marneffei is endemic, located in eastern India, and describes the first occurrence in India of P. marneffei in HIV-infected patients as well as the extension of the areas of P. marneffei endemicity westward to the northeastern state of Manipur.

Download Full-text

Atypical secondary syphilis presentation in a patient with human immunodeficiency virus infection: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2291-5 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 2

Author(s):

Nina Yancheva ◽

Elena Petrova ◽

Tatyana Tchervenyakova

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Developed Countries ◽

Skin Lesions ◽

Secondary Syphilis ◽

Immunodeficiency Virus ◽

Clinical Diagnoses ◽

Complete Reversal

Abstract Introduction Untreated syphilis may lead to severe complications. This infection has recently re-emerged in developed countries with a high number of cases coinfected with human immunodeficiency virus. In these patients, the skin lesions of secondary syphilis can be very atypical. Case presentation We report the case of a 38-year-old Bulgarian homosexual man who was coinfected with human immunodeficiency virus and syphilis. His skin contained multiple extensive necrotic lesions with abundant purulent secretion that covered his face, lips, scalp, and torso. Initial clinical diagnoses included varicella pustulosa and staphylococcal dermatitis. Human immunodeficiency virus infection in our patient had been established 2 years earlier in prophylactic studies, but had not been treated. Due to lack of penicillin, he was successfully treated with ceftriaxone, and the skin lesions underwent complete reversal. He also began antiretroviral therapy, which resulted in a significant effect on his immune status. Three months after the onset of antiretroviral therapy, he also achieved optimal viral suppression. Conclusion This case emphasizes the importance of considering cutaneous secondary syphilis in the differential diagnosis of any inflammatory cutaneous disorder in individuals infected with human immunodeficiency virus.

Download Full-text

A case of classic Kaposi sarcoma in an immunocompetent human immunodeficiency virus–negative Dominican man

SAGE Open Medical Case Reports ◽

10.1177/2050313x20938249 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2093824

Author(s):

Kush Gupta ◽

Aung Tun ◽

Ashish Gupta ◽

Leonard B Berkowitz ◽

Raheel Anwar ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Soft Palate ◽

Kaposi Sarcoma ◽

The United States ◽

Skin Lesions ◽

Immunosuppressive Drug ◽

Middle Aged ◽

Mucosal Surfaces ◽

Immunodeficiency Virus ◽

Classic Kaposi Sarcoma

Kaposi sarcoma is an uncommon tumor that primarily arises in the skin and mucosal surfaces, but may metastasize to the internal organs. Four main variants of Kaposi sarcoma are recognized as the following: classic Kaposi sarcoma, which occurs in middle-aged or elderly men; epidemic Kaposi sarcoma, associated with human immunodeficiency virus infection; iatrogenic Kaposi sarcoma seen in patients on immunosuppressive drug therapy; and endemic Kaposi sarcoma. This report is of a case of classic Kaposi sarcoma in 55-year-old immunocompetent and human immunodeficiency virus–negative Dominican man who had lived in the United States for 2 years, who presented with a 2-year history of skin lesions on his lower extremities and soft palate. Biopsy of the soft palate was consistent with Kaposi sarcoma. The patient was treated with paclitaxel with a good response. This case report demonstrates the importance of recognizing that classic Kaposi sarcoma, first described almost 150 years ago, can still present in immunocompetent middle-aged men of all ethnicities.

Download Full-text

Kaposi Sarcoma With Intravascular Primary Effusion Lymphoma in the Skin: A Potential Pitfall in HHV8 Immunohistochemistry Interpretation

International Journal of Surgical Pathology ◽

10.1177/1066896920917212 ◽

2020 ◽

Vol 28 (8) ◽

pp. 868-871

Author(s):

Cassandra Bruce-Brand ◽

Jonathan Rigby

Keyword(s):

Human Immunodeficiency Virus ◽

Primary Effusion Lymphoma ◽

Human Herpesvirus ◽

Kaposi Sarcoma ◽

Skin Lesions ◽

Human Herpesvirus 8 ◽

Positive Staining ◽

Herpesvirus 8 ◽

Immunodeficiency Virus ◽

Careful Assessment

Primary effusion lymphoma is a rare, clinically aggressive large B-cell neoplasm universally associated with human herpesvirus 8 that occurs in the setting of immune compromise. It is classically described as a lymphomatous effusion occurring within body cavities. Recently, however, solid tumor masses, and rarely an intravascular form, have been described. We report a case of a cutaneous intravascular primary effusion lymphoma occurring within ectatic vascular spaces of a Kaposi sarcoma skin lesion in a human immunodeficiency virus–positive adult. Human herpesvirus 8 immunohistochemistry was positive in the nuclei of the Kaposi sarcoma spindled cells as well as within large intravascular plasmacytoid cells. This unusual case highlights the importance of careful assessment of the nature of human herpesvirus 8–positive staining cells in an otherwise typical Kaposi sarcoma. A careful search for dual pathology in immune-compromised patients as well as the importance of histologic assessment of skin lesions in human immunodeficiency virus–positive patients is also highlighted.

Download Full-text

Clinical presentation of congenital syphilis in a rotavirus vaccine cohort study in Lusaka: a case series

Journal of Medical Case Reports ◽

10.1186/s13256-021-02745-1 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Nsofwa Sukwa ◽

Michelo Simuyandi ◽

Masuzyo Chirwa ◽

Yvonne Mutombo Kumwimba ◽

Obvious N. Chilyabanyama ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Antenatal Care ◽

Clinical Presentation ◽

Congenital Syphilis ◽

Case Series ◽

Skin Lesions ◽

Rotavirus Vaccine ◽

Rapid Plasma Reagin ◽

Immunodeficiency Virus ◽

Tract Infections

Abstract Background Despite an otherwise robust national antenatal clinic program, maternal and congenital syphilis remains an important public health issue in Zambia. This case series reports the clinical presentation of seven infants diagnosed with congenital syphilis in Lusaka, Zambia. Case presentations The cases in this series were incidental findings from a cohort of infants enrolled in a rotavirus vaccine immunogenicity study recruiting infants at 6 weeks of age. As part of clinical care for enrolled participants, we screened mothers of children who presented with adverse events of (i) repeated upper respiratory tract infections/coryza, (ii) skin lesions, and (iii) poor weight gain, for syphilis using rapid plasma reagin test. From a cohort of 214 mother–infant pairs enrolled between September and December 2018, a total of 115 (44.4%) of the mothers reported to have not been screened during antenatal care. Of these, four (3.5%) reported to have tested positive; and only two received treatment. Seven out of 57 (26.6%) children meeting the screening criteria had a positive rapid plasma reagin test result. The mean age at diagnosis was 4.5 months (1.3 months standard deviation), and the common presenting features included coryza (6/7), skin lesions (4/7), conjunctivitis (3/7), pallor/anemia (5/7), wasting (2/7), and underweight (5/7). Three of the seven infants were exposed to human immunodeficiency virus. Following diagnosis, all seven cases received standard treatment according to national treatment guidelines. That is, 6/7 cases received inpatient care with benzylpenicillin for 10 days, while 1/7 was treated as an outpatient and received daily procaine penicillin for 10 days. Conclusion These findings suggest that, though screening for syphilis is part of the standard antenatal care in Zambia, it is not offered optimally. There is urgent need to address programmatic shortcomings in syphilis screening and treatment to avoid long-term sequelae. Additionally, clinicians need to raise their index of suspicion and rule out syphilis when confronted with these clinical symptoms, regardless of the mother’s human immunodeficiency virus status.

Download Full-text

Leukocytoclastic vasculitis associated with nontyphoidal Salmonella in a patient infected with human immunodeficiency virus

International Journal of STD & AIDS ◽

10.1177/0956462419900847 ◽

2020 ◽

Vol 31 (4) ◽

pp. 383-386

Author(s):

Gonzalo Cornejo-Venegas ◽

Juan José Montenegro-Idrogo ◽

Cristhian Resurrección-Delgado ◽

Carolina Mendez-Guerra ◽

Andres Quevedo-Ramirez ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Hiv Infection ◽

Leukocytoclastic Vasculitis ◽

Clinical Stage ◽

Corticosteroid Treatment ◽

Skin Lesions ◽

Meningococcal Infection ◽

Immunodeficiency Virus ◽

History Of

A 27-year-old Peruvian woman living with human immunodeficiency virus (HIV) in clinical stage B3 and not on antiretroviral therapy presented with a ten-day history of fever, chills, night sweats and a two-day history of skin lesions. On physical examination, several erythematous-purplish lesions were found on the face and legs. Meningococcal infection was suspected and ceftriaxone was started. Blood culture grew nontyphoidal Salmonella enterica. A biopsy of the skin lesions showed leukocytoclastic vasculitis (LCV); therefore, corticosteroids were added. After two weeks of antibiotic and corticosteroid treatment, the lesions had resolved, but they recurred two days after treatment with prednisone was stopped. Corticosteroids and combination antiretroviral therapy were started simultaneously and the lesions resolved without recurrence. HIV infection has been associated with higher rates of skin lesions in salmonellosis. LCV has been described both in the setting of HIV infection and salmonellosis. However, our review of the literature found no previous cases of LCV in concurrent HIV and salmonellosis.

Download Full-text