Cytomegalovirus infection in the first year of life in human immunodeficiency virus-infected children: impact on survival and progression of the HIV disease.

BACKGROUND: Cytomegalovirus (CMV) is one of the most common opportunistic infections in AIDS patients. The aim of this study was to assess the influence of CMV infection in the first year of life and its the impact on survival and progression of the disease. MATERIAL/METHODS: This prospective cohort study included all children with a diagnosis of HIV infection in the first year of life followed at the University Hospital 12 de Octubre, Madrid. Urine culture was performed at birth or as soon as the diagnosis of HIV was given. RESULTS: Among the 81 patients studied, 16 presented a positive culture for CMV in urine during the first year of life. At 2 and 5 years of age, 23.6% and 39.6% of the children, respectively, died among those children without CMV infection, whereas 20% and 40% of children with acquired CMV died at this time point. Neither a greater progression of the disease nor any differences in the degree of immunosupression were observed among the children infected with CMV compared with those not infected. CONCLUSIONS: In this study no relationships between CMV infection during the first year of life and faster progression of HIV infection or lower survival or a greater degree of immunosuppression in HIV-infected children was observed.

Outpatient treatment with corticosteroids and antibiotics for acalculous cholecystitis in chronic granulomatous disease.

UNLABELLED: We report the outpatient management of acalculous colecistitis in an 18-y-old male with X-linked chronic granulomatous disease. The patient complained of abdominal pain and the initial ultrasound showed a gallbladder with a thickened wall. CONCLUSION: In chronic granulomatous disease, pain from a thickened gallbladder disappears after oral treatment with glucocorticoids and antibiotics.