First detection of Cryptosporidium DNA in blood and cerebrospinal fluid of HIV-infected patients.

Human cryptosporidiosis is an intestinal infection caused by different species belonging to the genus Cryptosporidium in both immunocompetent and immunocompromised individuals. The life cycle of Cryptosporidium sp. when affecting the digestive system is well known but the infection of other organs is less studied. Molecular methods are necessary for species and subtypes identification. The goal of this work is to propose a new approach that contributes to the diagnosis of the extra-intestinal dissemination process of Cryptosporidium infection. Cryptosporidium sp. was detected in stool and biopsy samples of two HIV-infected patients. DNA was extracted from feces, biopsy specimens, blood, and cerebrospinal fluid (CSF). All samples were analyzed by nested PCR-RFLP of the 18S rDNA, real-time PCR, and gp60 subtyping. Cryptosporidium DNA was detected in stool and tissue samples and it was also present in blood and CSF samples. Both cases were characterized as Cryptosporidium hominis subtype IeA11G3T3. This is the first report that demonstrates the presence of Cryptosporidium DNA in blood and CSF of HIV-infected patients.

Pulmonary toxoplasmosis in human immunodeficiency virus-infected patients in the era of antiretroviral therapy.

Toxoplasmosis is a severe opportunistic infection in patients infected with the human immunodeficiency virus (HIV). The lung is a major site of infection after the central nervous system. In this report we described two cases of pneumonia due to Toxoplasma gondii infection in HIV patients with antiretroviral therapy. Clinical and radiological abnormalities are not specific. Pulmonary toxoplasmosis should be considered in HIV-infected patients with late stage of HIV, CD4 count less than 100 cells/µl and a poor adherence to HAART.

[Brunner's gland adenoma: a rare tumor as cause of pyloric syndrome in an AIDS patient]. / Adenoma de glándulas de Brunner: un tumor raro como causa de sindrome pilórico en un paciente con SIDA.

Brunner's gland adenoma is a rare neoplasm that accounts for only the 0.008% of all benign duodenal tumors. Here we describe the case ofan HIV-seropositive man who developed a severe pyloric stenosis due to a Brunner's adenoma of the bulb and the first duodenal portion. Gastroduodenoscopy showed a large polypoid tumor that obstructed the pyloric region. The lesion was resected by surgery and a gastroduodenal anastomosis was made. The histopathologic examination of the surgical specimen showed a large proliferation of Brunner's glands into a large pedunculated polyp that confirmed the diagnosis of this hamartoma.

Sífilis maligna en un paciente con infección por VIH: Presentación de un caso y revisión de la literatura / Malignant syphilis in a patient infected by human immunodeficiency virus: Case report and literature review

Malignant syphilis is a rare form of secondary syphilis strongly associated with human immunodeficiency virus infection (HIV). This clinical form of the disease is characterized by atypical cutaneous ulcerative and disseminated lesions and systemic compromise that can delay the final diagnosis. There are only few reports in the medical literature about malignant lues in HIV-infected patients. Malignant syphilis should be considered in the differential diagnosis in HIV-infected patients with fever and ulcerative skin lesions. Here we describe a man who developed clinical cutaneous and systemic manifestations pathologically conirmed as malignant syphilis and we performed a review of the literature.

La sífilis maligna es una forma rara de presentación de lúes secundaria asociada a la infección por el virus de la inmunodeficiencia humana (VIH). Se caracteriza por lesiones cutáneas atípicas, ulceradas, costrosas y diseminadas, asociadas con síntomas generales inespecíficos que pueden retrasar el diagnóstico correcto. Existen sólo escasas publicaciones en la literatura médica acerca de sífilis maligna en pacientes con infección por VIH. La lúes maligna debe incluirse en el diagnóstico diferencial de los pacientes con VIH que consultan por fiebre y lesiones úlcero-costrosas diseminadas. Se describe el caso de un paciente con infección por VIH que desarrolló una sífilis maligna con confirmación diagnóstica a partir de los hallazgos histopatológicos y se realiza una revisión de la literatura científica sobre el tema.

[Malignant syphilis in a patient infected by human immunodeficiency virus. Case report and literature review]. / Sífilis maligna en un paciente con infección por VIH: Presentación de un caso y revisión de la literatura.

Malignant syphilis is a rare form of secondary syphilis strongly associated with human immunodeficiency virus infection (HIV). This clinical form of the disease is characterized by atypical cutaneous ulcerative and disseminated lesions and systemic compromise that can delay the final diagnosis. There are only few reports in the medical literature about malignant lues in HIV-infected patients. Malignant syphilis should be considered in the differential diagnosis in HIV-infected patients with fever and ulcerative skin lesions. Here we describe a man who developed clinical cutaneous and systemic manifestations pathologically confirmed as malignant syphilis and we performed a review of the literature.