RESUMO
We have described a case of fulminant echovirus infection that progressed rapidly to purpura and septic shock. To our knowledge, this is a previously unreported presentation of acute echovirus infection in an immunocompetent adult.
Assuntos
Infecções por Echovirus/microbiologia , Enterovirus Humano B/classificação , Púrpura/microbiologia , Choque Séptico/microbiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Infecções por Echovirus/sangue , Infecções por Echovirus/terapia , Humanos , Masculino , Púrpura/sangue , Púrpura/terapia , Respiração Artificial , Sorotipagem , Choque Séptico/sangue , Choque Séptico/terapiaRESUMO
Primary infection with the human immunodeficiency virus (HIV-1) has been associated with a self-limited illness resembling acute infectious mononucleosis. Pulmonary manifestations have been notably absent in published reports. The authors describe a 28-year-old homosexual male who presented with primary HIV-1 infection associated with CD8+ lymphocytic alveolitis. Diagnosis was delayed because HIV antibody was not detected by the Abbott ELISA, although the same and subsequent specimens were later found to be positive by Genetic Systems' ELISA and Western blot analysis. Lymphocytic alveolitis must be added to the expanding clinical spectrum of acute HIV-1 infection. The time to detection of seroconversion may vary with different immunoassays.
Assuntos
Soropositividade para HIV/complicações , Linfócitos , Fibrose Pulmonar/complicações , Adulto , Antígenos de Diferenciação de Linfócitos T/análise , Líquido da Lavagem Broncoalveolar/análise , Ensaio de Imunoadsorção Enzimática , Soropositividade para HIV/diagnóstico , Humanos , Linfócitos/imunologia , Masculino , Fibrose Pulmonar/diagnósticoRESUMO
To identify prognostic factors in acquired immunodeficiency syndrome (AIDS), the authors studied an inception cohort of 45 patients in a non-endemic area (Group I). The probability of survival was 67% six months after the diagnosis of AIDS and 32% at 12 months. As shown by multivariate Cox regression analysis, survivals were shorter (p less than 0.01) in patients 35 years old or older and in those who had anemia when AIDS was diagnosed. In patients with neither of these poor prognostic factors, the 12-month survival was 64%; in patients with one factor, it was 22%; and in patients with both factors, 0%. The prognostic significance of these two factors was validated in a second inception cohort of 50 patients (Group II): in patients with zero, one, and two poor prognostic factors, the 12-month survivals were 80%, 58%, and 26%, respectively. Other poor prognostic factors in Group I included disseminated Mycobacterium avium-intracellulare and the development of new opportunistic infections or neoplasms. The authors conclude that clinically important prognostic factors can be identified in AIDS patients. These findings should be considered in planning therapeutic trials and in counseling patients.