Identification of Novel Gammaherpesviruses in a South American Fur Seal ( Arctocephalus australis) with Ulcerative Skin Lesions.

There are few studies on pathogens affecting free-ranging pinnipeds from South America. We employed molecular techniques to identify a gammaherpesvirus infection by two putative novel herpesvirus species: Otariid herpesvirus 5 (OtHV-5), possibly associated with ulcerative cutaneous lesions, and Otariid herpesvirus 6 (OtHV-6) in a wild South American fur seal ( Arctocephalus australis) that stranded alive in Santa Catarina state, southern Brazil. Here we provide new information regarding pinniped herpesviruses, important for the design of future disease surveillance studies.

Cutaneous involvement by cytomegalovirus in a renal transplant recipient as an indicator of severe systemic infection.

Cytomegalovirus is an opportunistic virus that commonly affects immunosuppressed patients. Cutaneous involvement by this virus is rare and occurs in significantly immunocompromised hosts, with a poor prognosis. Skin ulcers may represent the first sign of systemic infection by cytomegalovirus in these patients. Herein, a case of a systemic infection by Cytomegalovirus presenting as genital and oral ulcers in a kidney-transplant recipient is reported.

Cutaneous involvement by cytomegalovirus in a renal transplant recipient as an indicator of severe systemic infection

Abstract Cytomegalovirus is an opportunistic virus that commonly affects immunosuppressed patients. Cutaneous involvement by this virus is rare and occurs in significantly immunocompromised hosts, with a poor prognosis. Skin ulcers may represent the first sign of systemic infection by cytomegalovirus in these patients. Herein, a case of a systemic infection by Cytomegalovirus presenting as genital and oral ulcers in a kidney-transplant recipient is reported.

A Potential Role for Mononuclear Phagocytes in Cutaneous Ulcer Development in Human Immunodeficiency Virus-Leishmania braziliensis Coinfection.

Skin ulcer development in cutaneous leishmaniasis due to Leishmania braziliensis infection is associated with a mononuclear cell infiltrate and high levels of tumor necrosis factor (TNF). Herein, we show that despite the absence of Leishmania-driven TNF, a cutaneous leishmaniasis patient with acquired immunodeficiency syndrome developed a skin ulcer. The presence of mononuclear phagocytes and high levels of TNF, chemokine (C-C motif) ligand 2 (CCL2), and metalloproteinase-9 in tissue are identified as potential contributors to immunopathology observed in L. braziliensis-infected patients.

Case for diagnosis.

Since the first reports and descriptions of AIDS in the early 1980s, herpetic infection has been considered as one of the most prevalent and opportunistic aids related infections in patients with retroviral diseases Infection by Herpes simplex type 2 (HSV-2), the etiologic agent responsible for 60% to 90% of the cases of genital herpes, is very common among patients suffering from AIDS. Herpes simplex type 2 infection may cause severe and prolonged (over a period of time of one month) mucocutaneous onset of the disease, being characterized as an aids defining clinical condition.

Caso para diagnóstico / Case for diagnosis

Desde as primeiras descrições da aids, no início da década de 1980, a infecção herpética é vista como uma das doenças oportunistas mais prevalentes em pacientes com retrovirose. A infecção pelo herpes-vírus simples tipo 2, agente etiológico de 60 a 90 por cento dos casos de herpes genital, é bastante comum em pacientes com aids. O acometimento mucocutâneo pelo herpes-vírus simples tipo 2 pode ser grave e prolongado (persistente por mais de um mês), sendo caracterizado como doença definidora de aids.

Since the first reports and descriptions of AIDS in the early 1980s, herpetic infection has been considered as one of the most prevalent and opportunistic aids related infections in patients with retroviral diseases Infection by Herpes simplex type 2 (HSV-2), the etiologic agent responsible for 60 percent to 90 percent of the cases of genital herpes, is very common among patients suffering from AIDS. Herpes simplex type 2 infection may cause severe and prolonged (over a period of time of one month) mucocutaneous onset of the disease, being characterized as an aids defining clinical condition.

[Ureterostomy cytomegalovirus infection presenting as stoma ulceration in a kidney allograft receptor: a case report]. / Ureteritis por citomegalovirus en receptor de trasplante renal. Informe de un caso con presentación inusual.

Cytomegalovirus (CMV) is the most common viral infection affecting transplant patients, but urinary tract involvement has been rare. Only a few cases of symptomatic ureteritis have been reported in renal transplant recipients. In previous reports the presentation of CMV ureteritis is obstructive nephropathy, often in the absence of systemic illness, or rarely it may also mimic allograft rejection with minimal obstructive symptoms. We describe an additional case of CMV ureteritis in a patient with cutaneous ureterostomy. The unusual clinical presentation with urinary infection symptoms and ureterostomy stoma ulceration constitute a very particular presentation. The increasing report cases with CMV ureteritis suggest an increase of this post-transplant complication.

Histoplasmosis as cause of penile ulcer in acquired immune deficiency syndrome (AIDS): three case reports.

BACKGROUND: Histoplasma capsulatum is the causative agent of American histoplasmosis. The relationship between disseminated histoplasmosis and AIDS has been well established. Widespread hematogenous dissemination of Histoplasma capsulatum in HIV positive patients can cause a plethora of clinical manifestations; virtually any organic system can be affected. However, genital ulceration by H. capsulatum in patients with AIDS is a real challenge during investigation of the infection due to the great variety of differential diagnoses that are involved. METHOD: The diagnosis was performed by histopathologic study; H. capsulatum was detected by silver staining (Grocott staining) and confirmed by immunocytochemistry. RESULTS: We report three cases of histoplasmosis in patients with AIDS, in which we observed genital ulcers, an unusual form of presentation of this disease. In one of these cases, the treatment resulted in total cure. CONCLUSION: The cases reported herein are to illustrate the plurality of pathologies and clinical manifestations, which may affect immunocompromised patients. The correct diagnosis of fungal diseases in these patients following well established treatment will improve the prognosis.

Mielitis aguda necrotizante en un paciente con SIDA / Acute necrotizing myelitis in an AIDS patient

In the setting of HIV infection, cytomegalovirus (CMV) and herpes simplex virus type 1-2 (HSV 1-2) can affect both the central and peripheral nervous systems. These agents can involve the spinal cord and produce a necrotizing transverse myelitis. This usually occurs in AIDS patients with severe immunodeficiency: CD4+ lymphocyte counts typically are less than 50 cell/microL. The clinical presentation, CSF and imaging studies can provide a high level of suspicion diagnosis. Prompt initiation of antiviral specific drugs is essential. We report a patient with an acute necrotizing myelitis (cauda equina syndrome) secondary to CMV and HSV infections (AU)

Prevalence and risk factors associated with perianal ulcer in advanced acquired immunodeficiency syndrome.

BACKGROUND: The aims of this study were to evaluate the prevalence of perianal ulcer in AIDS patients with advanced disease, and to investigate risk factors associated with these lesions. METHODS: A cross-sectional study was conducted to determine the prevalence and risk factors associated with the presence of perianal ulcer in AIDS patients. A type-specific polymerase chain reaction (PCR) assay was carried out for detection of herpes simplex virus (HSV) DNA on swabs obtained from the ulcerative lesions. RESULTS: In total, 272 hospitalized AIDS patients were included in the study, for evaluation of the risk factors associated with the lesion. Perianal ulceration was found in 25 of 272 patients (prevalence=9.2%). The presence of HSV DNA was shown by type-specific PCR in 22 of 23 (95.6%) patients. Multivariate analysis revealed that a history of esophageal candidiasis (odds ratio (OR)=15.1; 95% confidence interval (CI)=3.8-59.1) and a history of perianal ulcer (OR=19.2; 95% CI 6.4-58.1) were significant risk factors for the presence of perianal ulcer. CONCLUSION: We conclude that a history of perianal ulcer and a history of esophageal candidiasis were risk factors independently associated with perianal ulcer in AIDS patients with advanced disease.

Perianal cytomegalovirus ulcer in an HIV infected patient: case report and review of literature.

We report the case of a 25-year-old man with acquired immunodeficiency syndrome, presenting with perianal ulcer and diarrhea. He had positive immunocytochemical tests for Cytomegalovirus (CMV) in circulating polymorphonuclear cells (PMN). The biopsy specimen was suggestive of CMV infection, and specific immunoperoxidase for CMV antigens positively stained endothelial cells and fibroblasts. In this report we review cutaneous CMV infection in immunocompromised patients.

Detection and direct typing of herpes simplex virus in perianal ulcers of patients with AIDS by PCR.

The presence of herpes simplex virus type 1 (HSV-1) and HSV-2 in perianal ulcerations of 41 AIDS patients was assessed by virus culture and a type-specific PCR-based assay. HSV was isolated from the lesion site in 24 of 41 (58.5%) patients, and HSV DNA was detected by PCR in all 24 (100%) of these specimens. Additionally, PCR was used to detect HSV DNA in 12 of 17 (70.5%) HSV culture-negative samples. Thus, HSV genomic sequences could be demonstrated in 36 of 41 (87.8%) perianal ulcers in this series. Full agreement in HSV typing by either immunodot assay or PCR was seen in 24 samples that were positive by both virus culture and PCR. HSV-2 was demonstrated in 35 of 36 (97.2%) HSV-positive samples.