Treatment of Severe Cryptosporidium-Related Diarrhea with Octreotide in a Patient with AIDS

1988 ◽  
Vol 22 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Michael D. Katz ◽  
Brian L. Erstad ◽  
Cathryn Rose
Keyword(s):  
Gastrointestinal Hormones ◽  
Somatostatin Analog ◽  
Secretory Diarrhea ◽  
Inhibitory Effects ◽  
Severe Diarrhea ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Antiparasitic Drugs ◽  
Long Acting ◽  
Immunodeficiency Syndrome

Cryptosporidiosis commonly causes severe diarrhea in immunosuppressed patients. There currently are no antiparasitic drugs consistently effective for this infection. This case describes a 26-year-old hemophiliac patient with acquired immunodeficiency syndrome and cryptosporidiosis whose diarrhea improved with continuous intravenous administration of a long-acting somatostatin analog, octreotide. Somatostatin has a variety of inhibitory effects on gastrointestinal hormones as well as a possible nonspecific effect on gastrointestinal mucosal fluid and electrolyte secretion. The somatostatin analog should be considered for patients with secretory diarrhea refractory to other forms of therapy.

Gastric Toxoplasmosis as the Presentation of Acquired Immunodeficiency Syndrome

2005 ◽  
Vol 129 (4) ◽  
pp. e87-e90 ◽  
Author(s):  
Mihai Merzianu ◽  
Steven M. Gorelick ◽  
Voltaire Paje ◽  
Donald P. Kotler ◽  
Corazon Sian
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
English Literature ◽  
Human Immunodeficiency Virus Status ◽  
Old West ◽  
Immunosuppressed Patients ◽  
The Central Nervous System ◽  
Acquired Immunodeficiency ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome ◽  
Disseminated Disease

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.

scholarly journals Fungal Mastoiditis in AIDS Patients: Reported Cases

2011 ◽  
Vol 15 (02) ◽  
pp. 245-248
Author(s):  
Flavia Silveira ◽  
Gabriel Bijos Faidiga ◽  
Tassiana do Lago ◽  
Camila Carrara Yassuda ◽  
Eduardo Tanaka Massuda ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Antifungal Therapy ◽  
Acquired Immunodeficiency Syndrome ◽  
Aids Patients ◽  
Aspergillus Fumigates ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Fatal Complications

Summary Introduction: Fungal mastoidits by Aspergillus fumigates predominantly occurs in immunosuppressed patients. Diagnosis is usually hard and disease is potentially fatal. Treatment is comprised of antifungal therapy, surgical debridement and immunosuppression correction. Case Report: This article reports a case of fungal mastoiditis in a patient with acquired immunodeficiency syndrome (AIDS). The treatment performed was that of surgery associated with antifungal therapy. The patient's facial nerve was not affected, what does not exclude potentially fatal complications of mastoiditis.

BK Virus Renal Infection in a Patient With the Acquired Immunodeficiency Syndrome

1999 ◽  
Vol 123 (9) ◽  
pp. 807-811 ◽  
Author(s):  
Manuela Nebuloni ◽  
Antonella Tosoni ◽  
Renzo Boldorini ◽  
Guido Monga ◽  
Luca Carsana ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Renal Damage ◽  
Bk Virus ◽  
Transplant Patients ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Polymerase Chain ◽  
Immunodeficiency Syndrome ◽  
Inflammatory Infiltrates ◽  
Renal Infection

Abstract Background.—We describe herein a patient with the acquired immunodeficiency syndrome and renal failure due to biopsy-proven BK virus (BKV) infection. Three months after the diagnosis of the renal viral infection, his condition remained unchanged. Although BKV has previously been shown to be associated with ureteral stenosis and renal damage in renal transplant patients, to our knowledge, the literature contains only 3 cases describing the presence of BKV lesions in the kidneys of immunosuppressed patients who had not undergone transplantation. Methods.—The presence of BKV infection was demonstrated by means of histology, immunohistochemistry with polyclonal anti-SV40 antibody, immunoelectron microscopy, polymerase chain reaction, and enzymatic cleavage with BamHI. Results.—Histologic examination revealed interstitial inflammatory infiltrates and tubules with enlarged and eosinophilic nuclei. Conclusions.—The high frequency of latent BKV infection and its reactivation during immunosuppression suggest that the possibility of its involvement in renal damage should be considered in immunocompromised patients.

Ultrastructural diagnosis of cryptosporidium in a patient with acquired immunodeficiency syndrome (AIDS)

1993 ◽  
Vol 51 ◽  
pp. 418-419
Author(s):  
E. Ramirez ◽  
B. L. A. Ceseñas ◽  
F. Segovia
Keyword(s):  
Electron Microscope ◽  
Acquired Immunodeficiency Syndrome ◽  
Phosphate Buffer ◽  
Uranyl Acetate ◽  
Intestinal Biopsy ◽  
Intestinal Protozoan ◽  
Thin Sections ◽  
Severe Diarrhea ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Cryptosporidium sp is an intestinal protozoan that is well known as parasite of different animals,but recently it has been recognized as a cause of human disease, princippally since apparition of the acquired immunodeficiency syndrome (AIDS). In this kind of patients it produces severe diarrhea (loss of a stool volume up to 17 liters per day), this condition may be a major factor leading to death.Information about Cryptosporidiosis and AIDS incidence in developing countries is limited. In this paper we report the ultrastructural study of an intestinal biopsy from an hemophilic man,infected wit HIV through a blood transfussion that presented severe diarrhea.Jejunal biopsy specimen was obtained and prepared for electron microscope study. The specimen was fixed in 2.5% glutaraldehyde in 0.2 M phosphate buffer pH 7.2;postfixed in 1% osmium tetroxide in 0.2M phosphate buffer pH 7.2;dehydrated in ethanol and embedded in epoxy resin (Medcast). Thin sections obtained in a LKB ultratome V with a diamond knife, stained with uranyl acetate and lead citrate, were observed in a Zeiss EM109 electron microscope.

scholarly journals Epidemiology and pathogenesis of Kaposi's sarcoma–associated herpesvirus

2001 ◽  
Vol 356 (1408) ◽  
pp. 517-534 ◽  
Author(s):  
Chris Boshoff ◽  
Robin A. Weiss
Keyword(s):  
Kaposi's Sarcoma ◽  
Primary Effusion Lymphoma ◽  
Kaposi’S Sarcoma ◽  
Modes Of Transmission ◽  
Mediterranean Countries ◽  
Immunodeficiency Virus ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Different Parts

Kaposi's sarcoma (KS) occurs in Europe and the Mediterranean countries (classic KS) and Africa (endemic KS), immunosuppressed patients (iatrogenic or post–transplant KS) and those with acquired immunodeficiency syndrome (AIDS), especially among those who acquired human immunodeficiency virus sexually (AIDS–KS). KS–associated herpesvirus (KSHV or HHV–8) is unusual among herpesviruses in having a restricted geographical distribution. Like KS, which it induces in immunosuppressed or elderly people, the virus is prevalent in Africa, in Mediterranean countries, among Jews and Arabs and certain Amerindians. Distinct KSHV genotypes occur in different parts of the world, but have not been identified as having a differential pathogenesis. KSHV is aetiologically linked to three distinct neoplasms: (i) KS, (ii) primary effusion lymphoma, and (iii) plasmablastic multicentric Castleman's disease. The histogenesis, clonality and pathology of the tumours are described, together with the epidemiology and possible modes of transmission of the virus.

Toxoplasmosis

1991 ◽  
Vol 12 (8) ◽  
pp. 227-236
Author(s):  
Bishara J. Freij ◽  
John L. Sever
Keyword(s):  
Mononuclear Cells ◽  
Developmental Stages ◽  
Clinical Manifestations ◽  
Protozoan Parasite ◽  
Treatment Modalities ◽  
North African ◽  
Obligate Intracellular ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Toxoplasma gondii is an obligate intracellular parasite capable of infecting humans and a variety of other warm-blooded animals. The organism is distributed widely in nature and may infect as many as 1 of 3 persons worldwide. Most Toxoplasma infections are either asymptomatic or otherwise benign; notable exceptions include the infections of the developing fetus whose mother acquires an acute T gondii infection during gestation and of immunosuppressed patients, such as those with the acquired immunodeficiency syndrome (AIDS), in whom the illness may be severe or even fatal. The cat and other felines (such as the lynx) appear to be the only definitive hosts for this protozoan. The name Toxoplasma is derived from the Greek word toxon (meaning arc or bow) and is a reference to the shape of the organism. The gondi is a North African desert rodent related to the gerbil in whose splenic and hepatic mononuclear cells the parasite was observed initially. This article briefly reviews the biology of T gondii and its epidemiology in man and other animals, as well as its pathogenesis, clinical manifestations, methods for accurate diagnosis, and preventive strategies. Information on prenatal diagnosis and treatment modalities is emphasized. THE ORGANISM T gondii is a protozoan parasite that exists in three developmental stages: tachyzoite, tissue cyst, and oocyst.

scholarly journals Fungemia in a university hospital: an epidemiological approach

2011 ◽  
Vol 44 (6) ◽  
pp. 745-748 ◽  
Author(s):  
Fabíola Maria Marques do Couto ◽  
Daniele Patrícia Cerqueira Macedo ◽  
Rejane Pereira Neves
Keyword(s):  
Total Sample ◽  
University Hospital ◽  
Adult Males ◽  
Blood Samples ◽  
Epidemiological Monitoring ◽  
Dematiaceous Fungus ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Prevalent Species

INTRODUCTION: Fungemia corresponds to the isolation of fungi in the bloodstream and occurs mostly in immunosuppressed patients. The early diagnosis and treatment of these infections are relevant given the serious threat to the affected patients and possible spread to other organs, often becoming fatal. The growing number of fungemia associated with poor prognosis resulted in this research aiming to diagnose and assess the epidemiological aspects of hematogenous infections by fungi. METHODS: The study included 58 blood samples collected within a 1-year period, from patients at the Hospital das Clinicas, Federal University of Pernambuco, by venipuncture in vacuum tubes. Blood samples were processed for direct examination and culture and identification, conducted by observing the macroscopic and microscopic characteristics, as well as physiological characteristics when necessary. RESULTS: Eight (13.8%) episodes of fungemia were identified, accounting for the total sample, and these pathogens were Candida, Histoplasma, Trichosporon, Cryptococcus, and a dematiaceous fungus. C. albicans was the prevalent species, accounting for 37.5% of the cases. Most affected patients were adult males. There was no predominance for any activity, and the risk of acquired immunodeficiency syndrome was the underlying pathology most often cited. CONCLUSIONS: The isolation of fungi considered as emergent species, such as C. membranifaciens and dematiaceous species, highlights the importance of epidemiological monitoring of cases of fungemia in immunocompromised patients, as the therapy of choice depends on the knowledge of the aethiological agent.

Evaluation of Ganciclovir for Cytomegalovirus Disease

DICP ◽  
1989 ◽  
Vol 23 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Courtney V. Fletcher ◽  
Henry H. Balfour
Keyword(s):  
Overall Response Rate ◽  
Response Rate ◽  
Marrow Transplant ◽  
Transplant Recipients ◽  
Cytomegalovirus Disease ◽  
Pharmacokinetic Properties ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Fluid Penetration ◽  
Immunodeficiency Syndrome

Cytomegalovirus (CMV) infections are a common cause of morbidity and mortality in immunosuppressed patients. Ganciclovir is an acyclic deoxyguanosine analog structurally similar to acyclovir but with superior activity against CMV. The median ganciclovir concentration required to inhibit viral replication by 50 percent is 2.15 μmol versus 72 μmol for acyclovir. Pharmacokinetic properties of ganciclovir include biexponential decay with a terminal half-life of 2.5 hours, tissue uptake, cerebrospinal fluid penetration, and renal dependence for elimination. CMV treatment approaches have commonly used dosages of 3–15 mg/kg/d. In uncontrolled trials, the response rate of CMV retinitis is approximately 80 percent. The overall response rate for CMV pneumonitis has been approximately 50 percent. However, AIDS (acquired immunodeficiency syndrome) and other immunosuppressed patients appear to respond more favorably (~ 70 percent) than do marrow transplant recipients. Relapse is common once ganciclovir is stopped and maintenance therapy may be required for sustained benefit. Neutropenia appears to be the drug-limiting adverse reaction. Although the development of ganciclovir-resistant CMV, risk factors for neutropenia, and alternative administration strategies all need further study, ganciclovir appears to have a role in the treatment of cytomegalovirus disease.

scholarly journals IMMUNOCOMPROMISED STATUS A CAUSE OF OPPORTUNISTIC INTESTINAL INFECTION LEADING TO GRAM NEGATIVE SEPSIS

2011 ◽  
Vol 01 (01/03) ◽  
pp. 57-59
Author(s):  
Rekha Rai ◽  
Vimal Kumar Karnaker ◽  
Krishnaprasad M. S. ◽  
Ganesh H. R.
Keyword(s):  
Opportunistic Infections ◽  
Opportunistic Pathogens ◽  
Gram Negative ◽  
Immunodeficiency Virus ◽  
Hiv Antibodies ◽  
Lethal Complications ◽  
Immunosuppressed Patients ◽  
Immunocompromised Status ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

AbstractGram negative sepsis and intestinal opportunistic infections including Cryptosporidium, Isospora, Cyclospora, Microsporidia, S.stercoralis and Candida albicans are increasingly becoming prevalent in acquired immunodeficiency syndrome (AIDS) patients. These infections are clinically important primarily because many of these have the potential for serious and even lethal complications in immunosuppressed patients. Here, we are reporting a patient with Gram-negative sepsis, who was found to be co-infected with three of these opportunistic pathogens. She was also found to be positive for human immunodeficiency virus (HIV) antibodies. To our knowledge, this has been reported once previously, and serves as a reminder to actively exclude S.stercoralis infection in immunocompromised individuals presenting with bacteraemia.

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