scholarly journals Neurosyphilis with Concomitant Cryptococcal and Tuberculous Meningitis in a Patient with AIDS: Report of a Unique Case

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Jose Armando Gonzales Zamora ◽  
Luis Alberto Espinoza ◽  
Rita N. Nwanyanwu

Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression. We report the case of a newly diagnosed HIV/AIDS young man who was found to have neurosyphilis with Cryptococcus meningitis. After a few weeks of treatment and initiation of antiretroviral therapy, he was also diagnosed with tuberculous meningitis, which was probably unmasked by the development of immune reconstitution inflammatory syndrome (IRIS). To the best of our knowledge, this is the only case of reported neurosyphilis and meningitis caused concomitantly by Cryptococcus and Mycobacterium tuberculosis.

2021 ◽  
Author(s):  
Li Liu ◽  
Mingjuan Yuan ◽  
Siqing Sun ◽  
Jinrong Wang ◽  
Yi Shi ◽  
...  

Abstract Background: Metagenomic next-generation sequence (mNGS) is an emerging powerful pan-pathogen test for the diagnosis of infectious diseases. However, the application of mNGS in acquired immunodeficiency syndrome with opportunistic infections is limited to clinical cases reports and central nervous system infection.In this study, we evaluated the diagnostic value of mNGS in acquired immunodeficiency syndrome(AIDS) with opportunistic infections(OIs).Methods: From January 2018 to February 2021,86 cases were enrolled in this retrospective analysis. All patients underwent mNGS. Clinical data were recorded.Result: In the present study, mNGS identified 76 of 86 infection cases (88.37%).Human betaherpesvirus 5 (CMV) (40.70%), Human gammaherpesvirus 4 (EBV) (40.70%),pneumocystis (31.40%) were the most common pathogens detected. The sensitivity of mNGS (88.37%,76/86) was higher than that of culture (22.10%, 19/86),smear(7%,6/86) and PCR(46.51%,40/86).In the detection of viruses such as (CMV and EBV), the consistency between PCR and mNGS of CMV and EBV was 100%,73.33% respectively. All PCP cases were detected by mNGS. The consistency in detection of talaromyces between culture and mNGS was 75%.mNGS is superior to the common methods such as culture and smear in the detection of mycobacterium tuberculosis and non-mycobacterium tuberculosis. The mNGS findings led to changes in treatment strategies in 47/86 (54.65%) cases. Compared with the patients’treatment before mNGS, patients had lower rate of broad-spectrum antibiotic drugs use during clinical treatment after mNGS 78/86(90.70%) vs 34/86(39.53%)(P<0.0001). Conclusion: mNGS showed a satisfying diagnostic performance in acquired immunodeficiency syndrome with opportunistic infections. mNGS may lead to a more precise antimicrobial treatment and reduced the use of antibiotic medicine.


e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Christy B Tumbelaka

Abstract: Human Immunodeficiency Virus (HIV) is virus that causes Acquired Immunodeficiency Syndrome (AIDS), which is a retrovirus disease that characterized by the severe immunosuppression that cause opportunistic infection, secondary neoplasm and neurologic manifestations. Nervous system involvement in HIV infections may occur directly through the virus and indirectly as a result of opportunistic infections due to immunocompromised. This study aimed to determine the incidence of intracranial complication in HIV/AIDS patients who were hospitalized in Neurology Ward of RSUP Prof. Dr. R. D. Kandou Manado from July 2012 to June 2013. This study were a retrospective descriptive study using medical record of patients with HIV/AIDS. The results showed there were 36 patients with HIV/AIDS and 27 patients had intracranial complications. Tuberculous Meningitis was the most common type of complications with percentage (51,9%). Based on those 27 HIV/AIDS patients with intracranial complication, patients who were 25-34 years old (44%) have the most intracranial complication. Based on the gender percentage, it is dominated by male (59,3%) and based on the occupations, it is commonly came from entrepreneurs (29,6%). Conclusion: The incidences of intracranial complication in patients with HIV/AIDS were quite high on Tuberculous Meningitis, and it is dominated by male. The highest distributions were found on aged 25-34 whose occupation were entrepreneurs. Keywords: Intracranial Complication, HIV/AIDS, patients.   Abstrak: Human Immunodeficiency Virus (HIV) merupakan virus yang menyebabkan penyakit Acquired Immunodeficiency Syndrome (AIDS) yaitu suatu penyakit retrovirus yang ditandai dengan imunosupresi berat yang menimbulkan infeksi oportunistik, neoplasma sekunder, dan manifestasi neurologis. Keterlibatan sistem saraf pada infeksi HIV dapat terjadi secara langsung karena virus tersebut dan tidak langsung akibat infeksi oportunistik akibat imunokompromis. Penelitian ini bertujuan untuk mengetahui angka kejadian komplikasi intrakranial pada penderita HIV/AIDS yang di rawat inap di Bagian Neurologi RSUP Prof. Dr. R. D. Kandou Manado selama periode Juli 2012 – Juni 2013. Metode penelitian ini ialah deskriptif retrospektif dengan menggunakan catatan rekam medik penderita HIV/AIDS. Hasil peneitian memperlihatkan dari 36 pasien HIV/AIDS, terdapat 27 penderita yang memiliki komplikasi intrakranial dengan persentase jenis komplikasi intrakranial terbanyak yaitu Meningitis Tuberkulosis (51,9%). Dari 27 penderita HIV/AIDS yang memiliki komplikasi intrakranial paling banyak ialah pada kelompok umur 25-34 tahun (44,4%) sedangkan untuk jenis kelamin, didominasi oleh penderita berjenis kelamin laki-laki (59,3%), dan jenis pekerjaan terbanyak ialah wiraswasta (29,6%). Kesimpulan: Angka kejadian komplikasi intrakranial pada penderita HIV/AIDS yang cukup tinggi terdapat pada Meningitis Tuberkulosis dengan jenis kelamin terbanyak ialah laki-laki. Distribusi yang cukup tinggi pula ditemukan pada kelompok umur 25-34 tahun dengan jenis pekerjaan sebagai wiraswasta. Kata Kunci: Komplikasi Intrakranial, HIV/AIDS, penderita


2021 ◽  
Vol 5 (9) ◽  
pp. SC1-SC2
Author(s):  
Manisha Singh

Acquired immunodeficiency syndrome (AIDS) is caused by Human immunodeficiency virus (HIV). HIV infections cause a gradual decrease in CD4+ cells and these cells are an indicator of the immune system including the body’s natural defense system against pathogens and illness.1 AIDS is defined as the advanced stage of HIV infection with CD4 cell count less than 200/mm3. AIDS is characterized by immunosuppression which can result in several opportunistic infections, tumors, and cancers.


Author(s):  
George Price ◽  
Gary Pearl ◽  
Lizardo Cerezo

With the onset of the Acquired Immunodeficiency Syndrome (AIDS), a variety of opportunistic infections have now become prevalent as a complication of the Human Immunodeficiency Virus (HIV). These infections may be viral, bacterial, fungal, or protozoal.Toxoplasma gondii is a protozoan that can infect humans in parasitic symbiosis. In the past, toxoplasmosis was most commonly found as a congenital infection of neonates, but has become a prominent infection of patients with AIDS. The cystic stage of the organism may be found in the central nervous system, skeletal muscle, cardiac muscle, and visceral organs. The tachyzoites, or individual organisms, are found in a variety of tissues, cells, and body fluids. The route of infection is either by ingestion of the organism from material contaminated by feline feces, or from the ingestion of the coccidian oocysts from the meat of infected animals.


1995 ◽  
Vol 104 (8) ◽  
pp. 668-672 ◽  
Author(s):  
John G. Batsakis ◽  
Jae Y. Ro ◽  
Elizabeth E. Frauenhoffer

The acquired immunodeficiency syndrome and other causes of immunosuppression have ushered in a variety of opportunistic infections. One of these is bacillary angiomatosis, a vasoproliferative lesion whose principal causative agent is Rochalimaea henselae. Bacillary angiomatosis, while preponderantly a cutaneous affliction, can be systemic, including involvement of the head and neck mucous membranes. Molecular technology and epidemiologic studies used to identify the bacterial agent of bacillary angiomatosis have also uncovered R henselae as the organism responsible for most cases of cat-scratch disease. Why the same organism promotes two different histopathologic lesions, as seen in bacillary angiomatosis and cat-scratch disease, is unknown.


PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 763-765
Author(s):  
Edward R. Burns ◽  
Ben-Zion Krieger ◽  
Larry Bernstein ◽  
Arye Rubinstein

The mechanism underlying the prolonged activated partial thromboplastin time (APTT) seen in some pediatric patients with acquired immunodeficiency syndrome (AIDS) and opportunistic infections was studied. A circulating inhibitor of coagulation was demonstrated in three patients. The inhibitor appears to be an immunoglobulin that interferes with some of the phospolipid-dependent coagulation reactions of the intrinsic pathway. This "AIDS anticoagulant" does not predispose the patient to clinical bleeding despite its ability to cause a marked prolongation of the APTT. As such, careful laboratory diagnosis of the cause of abnormal coagulation test results is necessary for children with AIDS.


2005 ◽  
Vol 129 (4) ◽  
pp. e87-e90 ◽  
Author(s):  
Mihai Merzianu ◽  
Steven M. Gorelick ◽  
Voltaire Paje ◽  
Donald P. Kotler ◽  
Corazon Sian

Abstract We report a case of a 39-year-old West African man with unknown human immunodeficiency virus status diagnosed with gastric toxoplasmosis as the presenting manifestation of acquired immunodeficiency syndrome. Toxoplasma gondii is common in severely immunosuppressed patients and most frequently involves the central nervous system, followed by the eye, myocardium and skeletal muscle, lungs, bone marrow, and peripheral blood. For unclear reasons, gastrointestinal involvement is exceedingly rare and occurs in the context of severe immunosuppression and disseminated disease. To our knowledge, this is the first report in the English literature of a patient with isolated, manifest gastric toxoplasmosis without evidence of concomitant cerebral or extracerebral involvement. It is important for both the clinician and the pathologist to maintain a high index of suspicion for toxoplasmosis in immunosuppressed patients presenting with nonspecific symptoms of gastritis and radiologic and endoscopic presence of thickened gastric folds with or without ulceration.


Biomédica ◽  
2021 ◽  
Vol 41 (Supl. 1) ◽  
pp. 17-22
Author(s):  
Ana Luz Galván-Díaz ◽  
Juan Carlos Alzate ◽  
Esteban Villegas ◽  
Sofía Giraldo ◽  
Jorge Botero ◽  
...  

Cystoisospora belli is an intestinal Apicomplexan parasite associated with diarrheal illness and disseminated infections in humans, mainly immunocompromised individuals such as those living with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). An irregular administration of highly active antiretroviral therapy (HAART) in HIV patients may increase the risk of opportunistic infections like cystoisosporiasis.We describe here a case of C. belli infection in a Colombian HIV patient with chronic gastrointestinal syndrome and poor adherence to HAART. His clinical and parasitological cure was achieved with trimethoprim-sulfamethoxazole treatment. Although a reduction in the number of C. belli cases has been observed since the use of HAART, this parasite still has to be considered as a differential diagnosis of diarrheal disease in HIV/AIDS patients.Effective interventions enhancing adherence to HAART should be included in HIV patient care programs.


2008 ◽  
Vol 13 (36) ◽  
Author(s):  
H Cortes Martins ◽  
M T Paixão

Portugal has been the western European country with the highest rate of notified acquired immunodeficiency syndrome (AIDS) cases since 1999 and human immunodeficiency virus (HIV) infection cases since 2000. Nonetheless, exact information on the magnitude and trends of recently acquired infections is missing. In a cross-sectional study we aimed to determine HIV prevalence, the proportion of recently acquired infections and the incidence among patients attending a Sexually Transmitted Infections (STI) clinic and among HIV positive cases tested at the AIDS Reference Laboratory (ARL), by using the Avidity Index (AI) of antibodies to identify recent HIV-1 seroconversions. Demographic and behavioural data were collected. At the STI clinic 253 patients were enrolled, 16 were found to be HIV infected (14 HIV-1, 2 HIV-2) and a prevalence of 6.3% was obtained. Four recent HIV-1 infections were identified and the HIV-1 incidence was 3.3% per year. At the ARL, 332 newly diagnosed cases of HIV-1 infection were studied, 59 (17.8%) were recent infections and an annual incidence of 4.1% was estimated. These findings support STI clinics as key sentinel sites for recently acquired HIV infections and illustrate the viability of testing for recent HIV infections in these settings and reinforce the value of this method in the surveillance for better monitoring current trends of the HIV/AIDS epidemic in Portugal.


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