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1.
Pan Afr Med J ; 33: 326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692828

RESUMO

Introduction: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide. The prevalence of HIV among children with TB in moderate to high prevalence countries ranges between 10% and 60%. This study aimed to determine the prevalence of HIV infection among children treated for TB in Directly Observed Treatment Short-Course (DOTS) clinics in Lubumbashi and to identify risk of death during this co-infection. Methods: This is a cross-sectional study of children under-15, treated for tuberculosis from January 1, 2013 to December 31, 2015. Clinical, paraclinical and outcome data were collected in 22 DOTS of Lubumbashi. A statistical comparison was made between dead and survived HIV-infected TB children. We performed the multivariate analyzes and the significance level set at p-value <0.05. Results: A total of 840 children with TB were included. The prevalence of HIV infection was 20.95% (95% CI: 18.34-23.83%). The mortality rate was higher for HIV-infected children (47.73%) compared to HIV-uninfected children (17.02%) (p<0.00001). Age <5 years (aOR=6.50 [1.96-21.50]), a poor nutritional status (aOR=23.55 [8.20-67.64]), and a negative acid-fast bacilli testing (aOR=4.51 [1.08-18.70]) were associated with death during anti-TB treatment. Conclusion: TB and HIV co-infection is a reality in pediatric settings in Lubumbashi. High mortality highlights the importance of early management.


Assuntos
Antituberculosos/administração & dosagem , Infecções por HIV/epidemiologia , Estado Nutricional , Tuberculose/epidemiologia , Criança , Pré-Escolar , Coinfecção , Estudos Transversais , República Democrática do Congo/epidemiologia , Terapia Diretamente Observada , Feminino , Infecções por HIV/mortalidade , Humanos , Masculino , Prevalência , Fatores de Risco , Tuberculose/tratamento farmacológico , Tuberculose/mortalidade
2.
Vestn Oftalmol ; 135(5): 61-69, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714514

RESUMO

INTRODUCTION: The current epidemic situation in Russia is characterized by increasing rate of co-infection (HIV/tuberculosis). Damage to the organ of vision is more common among patients with this pathology, presenting significant difficulties in diagnosis of the ophthalmic manifestations. High-tech imaging method - optical coherence tomography (OCT) allows exploration of the eye tissues with high accuracy and depth, as well as evaluation of the structure of the choroid and microcirculation parameters of the anterior and posterior eye segments.


Assuntos
Coinfecção , Infecções por HIV , Tuberculose , Corioide , Infecções por HIV/complicações , Humanos , Federação Russa , Tomografia de Coerência Óptica , Tuberculose/complicações
3.
Afr Health Sci ; 19(2): 1938-1946, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656477

RESUMO

Background: Co-infection of HBV with HIV is associated with significant morbidity and mortality globally. In spite of increasing reports of HIV/HBV co-morbidities in Nigeria, little or no data exists on this subject in Anyigba. Therefore, we determined the prevalence of hepatitis B surface antigenemia among HIV positive patients on anti-retroviral treatment programme in Anyigba, Kogi State, North-Central Nigeria. Methods: Sera samples obtained from 200 consented HIV patients were screened for HBsAg using the commercial rapid test membrane-based qualitative immunoassay. A structured questionnaire was used to collect information on patients' demographic variables and probable risk factors for HBV transmission. Results: Overall, 3.5% of HIV patients were seropositive to HBsAg and the difference between seroprevalence rates and patients' age as well as gender was not statistically significant (p>0.05). There was significant difference between patients' demographic variables such as marital status (p=0.013) and educational level (p=0.004) and HBsAg seropositivity. Patients with a history of surgical applications (p=0.01) and who indulged in alcoholism (p=0.03) significantly had higher rates of concomitant HIV/HBV infection in the study area. Conclusion: Our findings underscore the importance of routine screening for HBV in the HIV infected populations especially in developing countries where the infection is endemic. We advocate for public enlightenment programmes on routes of virus acquisitions with a view to reduce the morbidity and mortality associated HIV/HBV co-infection.


Assuntos
Infecções por HIV/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Coinfecção/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Hepatite B/complicações , Hepatite B/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
4.
Medicine (Baltimore) ; 98(40): e17393, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577747

RESUMO

RATIONALE: Bacteremia caused by polymicrobial infections are rare but dangerous. We report a case of hepatic abscess combined with polymicrobial bacteremia in a 49-year-old male patient after surgery and transcatheter arterial chemoembolization (TACE). PATIENT CONCERNS: The patient was admitted to hospital with metastatic liver cancer for periodic chemotherapy and developed a high fever and tenderness to the liver following surgery and TACE. DIAGNOSIS: Hepatic abscess combined with polymicrobial bacteremia. INTERVENTIONS: The clinician formulated a therapy in accordance with the drug susceptibility test and the empirical drug use for anaerobic bacteria. A comprehensive treatment plan was adopted, on the basis of the combination of nitrazole and imipenem as anti-infection drugs as well as continuous abscess drainage. OUTCOMES: After comprehensive therapy, the patient was ultimately discharged without any residual symptoms. LESSONS: Bloodstream infection caused by multiple bacteria increases the difficulty of anti-infection treatments, leading to poor treatment outcome and high mortality. Therefore, a fast and accurate diagnosis of polymicrobial bacteremia is key for initiation of an effective antimicrobial treatment. Additionally, pre-operative prophylactic antibiotics are advisable when patients have a history of abdominal surgery and are immune-compromised.


Assuntos
Bacteriemia/etiologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Abscesso Hepático/etiologia , Neoplasias Hepáticas/terapia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Carcinoma Hepatocelular/cirurgia , Coinfecção , Drenagem , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica
5.
Pan Afr Med J ; 33: 163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565125

RESUMO

Viral hepatitis is a serious public health problem. Its epidemiology is not precisely known in Morocco. Our objective was to assess the prevalence of HBV and HCV in a particular population of "blood donors" at the Regional Blood Transfusion Centre in Oujda. A retrospective study was conducted from May 1, 2013 to May 31, 2015. Thirty-one thousand nine hundred and fifty-two blood donors were tested. Antigen detection was made according to ELISA technique (MonolisaTMHBs Ag ULTRA). HCV research was performed by ELISA using the kit « Monolisa HCV Ag-Ab ULTRA ¼. 177 blood donors included, they are divided into 155 male (87.6%) and 22 female (12.4%) subjects with a ratio of 7. The average age was 37.64 ± 12 years. Six cases were positive for HCV with an overall prevalence of 0.02%. The population study by sex shows a prevalence of 0.004% for 23177 male sera and 0.057% for 8775 female sera. Six donors were HCV positive, of which 05 were female (83.33%) and one was male (16.66%). The average age was 43 ± 14 years. Co-infection with HCV HBV-HCV and HCV-Syphilis and HCV-HIV are absent. Co-infection with HBV and HIV was found in one case. HBV-syphilis co-infection was found in 04 cases. Chronic viral hepatitis is a real global health problem. Its prevalence is currently estimated at 0.55% for HBV and 0.02% for HCV, reclassifying Morocco as a low endemic area. The prevention remains the most effective method to successfully control HBV and HCV infection.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Coinfecção , Ensaio de Imunoadsorção Enzimática , Feminino , Antígenos de Superfície da Hepatite B/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Sífilis/epidemiologia , Adulto Jovem
6.
J Biol Regul Homeost Agents ; 33(5): 1437-1449, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637902

RESUMO

Influenza has frequently been epidemic in recent years. However, the mechanisms of severe pneumonia with postinfluenza Streptococcus pneumoniae (SP) secondary infection have not been fully understood. In this study, we explored the mechanisms of pneumonia in postinfluenza A virus (IAV) infection via a mouse model. Mice were intranasally inoculated with SP three days after IAV inoculation. We then collected samples at three time points to dynamically observe the pathological progression. In IAV infection alone, lymphocyte infiltration and widened alveolar intervals were observed. In the blood, levels of the CD19+, CD19+CD21+ and CD19+CD79ß+B lymphocyte subpopulations were reduced, and IFN-γ and IL-10 were elevated. Slight atrophy was seen in the spleen, which was due to splenic B lymphocyteinitiated apoptosis through the mitochondrial pathway. When SP infection occurred after IAV infection, the pulmonary inflammation was significantly aggravated; a fair number of lymphocytes and neutrophils infiltrated simultaneously with exfoliated bronchial epithelial cells, vascular endothelial cells, widened alveolar septum and hemorrhaging. Increasing edema fluid and bacteria accumulated in the alveolar cavity. Decreased CD19+, CD19+CD21+ and CD19+CD79ß+B lymphocyte subpopulations and increased interferon gamma (IFN-γ) or interleukin 10 (IL-10) were more prominent compared to those with viral infection alone. Spleen atrophy resulting from coinfection was more obvious because of massive splenic B lymphocyte apoptosis through the mitochondrial pathway compared to viral infection alone. This study shows that although inflammation caused by SP infection alone was temporary, preceding IAV infection provided favorable conditions for SP colonization and multiplication by destroying lung structure and suppressing humoral immunity. Synergistic IAV-SP coinfection is likely to facilitate more SP colonization and promote B lymphocyte-suppression and reduction. Eventually, the pneumonia worsened.


Assuntos
Linfócitos B/imunologia , Infecções por Orthomyxoviridae/imunologia , Infecções Pneumocócicas/imunologia , Pneumonia Bacteriana/imunologia , Animais , Apoptose , Linfócitos B/citologia , Coinfecção/microbiologia , Coinfecção/virologia , Células Endoteliais , Vírus da Influenza A , Pulmão , Camundongos , Infecções por Orthomyxoviridae/microbiologia , Infecções Pneumocócicas/virologia , Streptococcus pneumoniae
7.
Mymensingh Med J ; 28(4): 920-924, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599261

RESUMO

The diagnosis of mycotic lung infection in pulmonary TB patients remains misdiagnosed because of its non-specific clinical manifestations which mimics the symptoms of TB. Physicians have to rely on the investigation but as radiology and pathology cannot probe the appropriate diagnosis, conventional microbiology or PCR testing continue as an essential mode for the diagnosis. In developing country like India PCR is not cost effective. Thus, Direct microscopy by KOH (10%), Gram's staining & Culture remains only option for identification. A three-year cross-sectional study was carried out in the Department of Microbiology, Maharishi Markandeshwar Institute of Medical Science & Research, Mullana, India from August 2015 to August 2018. On 300 LED positive sputum samples collected from previously treated cases of pulmonary TB. Early morning sputum was collected and subjected to KOH 10%, Gram's staining afterwards cultured on Sabouraud Dextrose Agar and species identification was done by LPCB preparation. In 300 LED smear positive samples, the dominant pathogens were C. albicans (43.3%), followed by C. non-albicans (26.7%), A. fumigatus (21.7%) etc. ATT administration for 5-8 months' duration of illness showed highest fungal infection (45%) and maximum growth of fungus was seen in the Autumn season (45%). The co-occurrence of fungi with tubercle bacteria adds fatal consequences thus routine screening is recommended for proper diagnosis and early treatment of mycotic infection in the patients of Pulmonary TB on ATT.


Assuntos
Coinfecção , Tuberculose/microbiologia , Estudos Transversais , Fungos , Humanos , Índia/epidemiologia , Sensibilidade e Especificidade , Tuberculose/epidemiologia
8.
Bull Cancer ; 106(11): 1008-1022, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31606139

RESUMO

With more than 3300 new cases and almost 2500 deaths each year, cervical cancer (CC) ranks second among female cancers in Moroccan women. The majority of cases occurs in women aged 50 and over. In absence of a national cancer registry, data published in Morocco are limited to the number of cases recorded in some oncology centers, so the incidence of this cancer is likely much higher than estimated. A Moroccan national program against CC based on the practice of visual inspection after application of acetic acid was set up in 2010, allowing both screening and possibly immediate treatment of (pre)cancerous lesions. However, this program has not been implemented in all regions of the country. The CC develops slowly and most often without any symptoms, and so it is diagnosed at an advanced stage of the disease. Virtually, all CC are associated with persistent infection of high risk human papillomavirus (HPV), particularly HPV16 and 18. For more than ten years, two prophylactic vaccines targeting these two HPV genotypes have been marketed. They have proved their excellent immunogenicity and efficacy and they are well tolerated. However, HPV vaccine is not yet recommended by health authorities in Morocco. In this literature review, we focused on the current situation of CC, the prevalence of HPV infection and the prevention strategies against CC in Morocco.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Lesões Pré-Cancerosas/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Ácido Acético/administração & dosagem , Adulto , Algoritmos , Coinfecção/epidemiologia , Detecção Precoce de Câncer/métodos , Feminino , Infecções por HIV/epidemiologia , Papillomavirus Humano 16/imunologia , Papillomavirus Humano 18/imunologia , Humanos , Incidência , Indicadores e Reagentes/administração & dosagem , Pessoa de Meia-Idade , Marrocos/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/administração & dosagem , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/virologia , Prevenção Primária , Sistema de Registros/estatística & dados numéricos , Gestão de Riscos , Prevenção Secundária , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia
9.
F1000Res ; 82019.
Artigo em Inglês | MEDLINE | ID: mdl-31583080

RESUMO

Trichomonas vaginalis is the most common, curable non-viral sexually transmitted infection (STI) worldwide. Despite this burden of disease, it is not currently a reportable disease in the United States. Recent advances in the epidemiology, diagnosis, and management of T. vaginalis infection are described in this article. This includes updated global and U.S. prevalence data in women and men as well as recent epidemiological data in HIV-infected individuals and pregnant women. Advances in molecular diagnostics are also reviewed, as are data from recent clinical trials regarding the treatment of trichomonas in women.


Assuntos
Tricomoníase/diagnóstico , Tricomoníase/epidemiologia , Tricomoníase/terapia , Coinfecção , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Gravidez , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/terapia , Trichomonas vaginalis , Estados Unidos
10.
11.
Cent Eur J Public Health ; 27(3): 223-228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580558

RESUMO

OBJECTIVE: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. METHODS: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. RESULTS: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. CONCLUSION: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.


Assuntos
Coinfecção , Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , HIV , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Retrospectivos , Comportamento Sexual/estatística & dados numéricos , Sífilis/epidemiologia , Turquia
12.
An Bras Dermatol ; 94(4): 446-448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644618

RESUMO

Necrolytic acral erythema is a distinct erythema that has been described as an extrahepatic manifestation of hepatitis C virus infection. Most reported cases have been in Africa, especially Egypt. We report the first case (to the best of our knowledge) of necrolytic acral erythema in a Chinese patient with HCV and HBV coinfection. We aim to increase awareness for recognizing this condition in the Chinese population.


Assuntos
Coinfecção/complicações , Eritema/patologia , Eritema/virologia , Hepatite B/complicações , Hepatite C/complicações , Adulto , China , Coinfecção/patologia , Extremidades/patologia , Hepatite B/patologia , Hepatite C/patologia , Humanos , Masculino , Necrose/virologia
13.
BMC Infect Dis ; 19(1): 767, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477055

RESUMO

BACKGROUND: Tuberculosis (TB) is among the world's top public health challenges and the leading killer of people with HIV, yet is a treatable disease. This study aimed to assess, in a real-world setting, the implementation of antiretroviral therapy (ART) and Cotrimoxazole preventive therapy (CPT) policy, specific interventions proven to benefit patients in HIV-associated TB care. METHODS: This retrospective cohort study was conducted in Botswana in the Serowe/Palapye district, a largely urban district with a high burden of HIV-associated TB with a high case fatality, at Segkoma and Palapye hospitals and their feeder clinics. Between 1 January 2013 and 31 December 2013, confirmed HIV-positive patients aged ≥15 years with a confirmed TB diagnosis and medical record available were included in the analysis. The Kaplan-Meier method was used to compare time to death for the group of patients on ART and the group of patients not on ART during TB treatment. Cox proportional hazard regression was undertaken to identify predictors of mortality. RESULTS: Of the 300 patients included in the study, 217 (72%) were ART experienced at TB diagnosis. Of these, 86 (40%) had TB within 3 months following ART initiation. Of the 83 (28%) patients who were ART-naïve at TB diagnosis, 40 (48%) were commenced on ART during TB treatment, with 24 (60%) patients commencing within 4 weeks following TB treatment initiation. The overall ART uptake was 84%, while cotrimoxazole preventive therapy uptake was 100%. There were 45 deaths (15%), ART-experienced patients during TB treatment accounted for 30 deaths (30/257; 14%), while those who were not ART-experienced during TB treatment accounted for 15 deaths (15/43; 35%). There was a significant difference in survival time between patients with no ART use during TB treatment and those with ART use during TB treatment (log rank p < 0.001). Patients with no ART use during TB treatment were more likely to die within the first 2 months. CONCLUSION: The implementation of CPT policy is a substantial success. Strengthening the implementation of ART policy could improve survival among HIV-associated TB patients.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Antirretrovirais/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Tuberculose/tratamento farmacológico , Tuberculose/mortalidade , Adulto , Botsuana/epidemiologia , Coinfecção/tratamento farmacológico , Coinfecção/mortalidade , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , HIV/fisiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Implementação de Plano de Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tuberculose/complicações , Tuberculose/virologia
14.
Arch Virol ; 164(11): 2735-2745, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31486907

RESUMO

Koala retrovirus (KoRV) is unique among endogenous retroviruses because its endogenization is still active. Two major KoRV subtypes, KoRV-A and B, have been described, and KoRV-B is associated with disease and poses a health threat to koalas. Here, we investigated the co-prevalence of KoRV-A and KoRV-B, detected by type-specific PCR and sequencing, and their impact on the health of koalas in three Japanese zoos. We also investigated KoRV proviral loads and found varying amounts of genomic DNA (gDNA) in peripheral blood mononuclear cells (PBMCs). We found that 100% of the koalas examined were infected with KoRV-A and 60% (12/20) were coinfected with KoRV-B. The KoRV-A sequence was highly conserved, whereas the KoRV-B sequence varied among individuals. Interestingly, we observed possible vertical transmission of KoRV-B in one offspring in which the KoRV-B sequence was similar to that of the father but not the mother. Moreover, we characterized the KoRV growth patterns in concanavalin-A-stimulated PBMCs isolated from KoRV-B-coinfected or KoRV-B-uninfected koalas. We quantified the KoRV provirus in gDNA and the KoRV RNA copy numbers in cells and culture supernatants by real-time PCR at days 4, 7, and 14 post-seeding. As the study population is housed in captivity, a longitudinal study of these koalas may provide an opportunity to study the transmission mode of KoRV-B. In addition, we characterized KoRV isolates by infecting tupaia cells. The results suggested that tupaia may be used as an infection model for KoRV. Thus, this study may enhance our understanding of KoRV-B coinfection and transmission in the captive koalas.


Assuntos
Retrovirus Endógenos/genética , Gammaretrovirus/patogenicidade , Phascolarctidae/virologia , Infecções por Retroviridae/epidemiologia , Infecções por Retroviridae/veterinária , Animais , Animais de Zoológico/virologia , Linhagem Celular , Coinfecção/veterinária , Coinfecção/virologia , Retrovirus Endógenos/classificação , Retrovirus Endógenos/isolamento & purificação , Feminino , Gammaretrovirus/classificação , Gammaretrovirus/genética , Gammaretrovirus/isolamento & purificação , Japão/epidemiologia , Masculino , Provírus/genética , Infecções por Retroviridae/virologia , Tupaia/virologia , Carga Viral
15.
Medicine (Baltimore) ; 98(36): e17040, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490394

RESUMO

RATIONALE: Syphilis can share clinical features with autoimmune diseases, such as cutaneous Lupus or rheumatoid arthritis. Moreover, secondary syphilis can have visceral involvement, thus affecting the kidney. Syphilitic nephropathy causes nephrotic syndrome with a classic membranous pattern. We present a unique presentation of a co-infection by syphilis and parvovirus B19 sharing all the biological and histological features of proliferative lupus nephritis (LN). PATIENT CONCERNS: We present a case of a 71-year-old Caucasian male returning from a trip to Asia presenting with nephrotic syndrome with antinuclear antibodies (ANA) positivity. DIAGNOSES: Because of nephrotic syndrome a kidney biopsy was performed. It demonstrated a membranous nephropathy with extracapillary proliferation and a full house pattern (presence of IgA, IgG, IgM and C1Q deposits) on immunofluorescence (IF), highly suggestive of LN class III and V. However, several atypical clinical features notably the age, sex of the patient and the history of travel prompt us to search for another cause of nephropathy. INTERVENTIONS: A serology was positive for syphilis and a PCR in the renal biopsy was also positive for parvovirus B19. Thus, a co-infection by syphilis and parvovirus B19 was funded to be the cause of the renal lesions. OUTCOMES: The proteinuria improved; a course of antibiotic was administrated because of neurologic syphilitic involvement (presence of headache with positive syphilis serology in the CSF). LESSONS: A co-infection by syphilis and parvovirus B19 can share all the biological and histological features of proliferative LN and must be recognized as a cause of pseudo-lupus nephritis.


Assuntos
Eritema Infeccioso/diagnóstico , Nefrite Lúpica/diagnóstico , Sífilis/diagnóstico , Idoso , Coinfecção , Diagnóstico Diferencial , Eritema Infeccioso/complicações , Humanos , Masculino , Sífilis/complicações
16.
Psychiatr Danub ; 31(Suppl 3): 299-307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488744

RESUMO

INTRODUCTION: There is increasing awareness that Lyme borreliosis (LB) and traumatic brain injury (TBI) may cause mental health symptoms. TBI and Lyme disease compromise the health and activities of millions of patients per year. The chronic symptoms and disability of TBI and Lyme disease share a similar clinical presentation. We have identified an alarming number of individuals suffering from post-concussion syndrome (PCS) that are refractory to care and that have serologically tested positive for Lyme disease. SUBJECTS AND METHODS: A single-center retrospective review of patient charts that were symptomatic a minimum of one year after a TBI that were tested for Lyme disease to ascertain if there was a relationship. RESULTS: 217 PCS patient records (93 females with a mean age of 34 years, 120 males with a mean age of 40 years and 4 individuals with unknown gender) were included in the review. 38% had a positive Western Blot Igenex IgM. There was a statistically significant relationship of a positive Western Blot Igenex IGM predicting chronic PCS Pearson χ2(1)=6.8866, P=0.009, Fisher's exact score p=0.015 and φ=0.2813 representing a moderate effect size. CONCLUSIONS: Long term PCS over one year's duration is associated with undiagnosed Lyme disease. There was statistical and substantive significance between individuals with chronic PCS having a positive Western Blot Igenex IgM. Males were more likely to have a positive Western Blot Igenex IgM than females.


Assuntos
Coinfecção/epidemiologia , Doença de Lyme/epidemiologia , Síndrome Pós-Concussão/epidemiologia , Adulto , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos
17.
Acta Virol ; 63(3): 292-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31507195

RESUMO

Dengue, considered the most important arthropod-borne viral disease affecting humans, is transmitted by the bite of mosquitoes of the genus Aedes and caused by one of the four distinct serotypes of dengue virus (DENV-1, -2, -3 and -4). Infection with one of the four serotypes provides lifelong homotypic immunity. However, immunity against the heterologous serotypes is transient. As a consequence, secondary infection may lead to severer manifestations due to cross-reactivity of antibodies and T-cells. Over 500,000 people are hospitalized every year and around 2,5 million, living in endemic areas, are at risk of infection. Given the background, the development of vaccines and anti-DENV drugs is of the utmost importance, as is the characterization of an animal model for testing them. The purpose of this study was to investigate ultrastructural alterations caused by DENV secondary infection in BALB/c mice heart. To achieve our goal, six BALB/c mice were infected with DENV-1 and, 4 months later, reinfected with DENV-2. Uninfected mice were used as negative controls. Heart samples were collected and processed for ultrastructural and histopathological analysis. Our results showed edema, endothelium activation characterized by the presence of transport vesicles, free platelets in interstitium, mitochondria presenting rarefied matrix and degenerated cristae, and disorganization of muscle fibers. These results point not only to BALB/c mice susceptibility to DENV infection, but also to the fact that, although it is not an often reported occurrence, dengue can lead to heart damage. Keywords: dengue; experimental model; reinfection; BALB/c mice.


Assuntos
Coinfecção , Vírus da Dengue , Dengue , Miocárdio , Animais , Dengue/patologia , Dengue/virologia , Modelos Animais de Doenças , Coração/virologia , Camundongos , Camundongos Endogâmicos BALB C , Miocárdio/patologia
18.
Pan Afr Med J ; 33: 120, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489098

RESUMO

Introduction: This study aimed to describe the epidemiological, clinical and evolutionary profile of patients treated for tuberculosis at the Regional Hospital of Maradi. Methods: We conducted a retrospective, descriptive and analytical study of data from the medical records of patients treated for tuberculosis from 1st January 2015 to 31st December 2017. Results: A total of 595 patients were followed (406 men, 68.24%, and 189 women, 31.76%) with a prevalence of 27,71%. The average age of patients was 42.3 ranging from 13 months to 85 years; 70.5% of these patients were from urban areas. Merchants represented 36.9% of the cases. Bacterial test was positive in 64.7% of cases. Functional signs included: coughing (99.5%), fever (79.5%), and chest pain. Pulmonary tuberculosis represented 78.7% of cases. Therapy was effective in 81.28% of cases. HIV prevalence was 13.6%, lethality 10.42% (40.4% of patients died from TB/HIV co-infection). Conclusion: Tuberculosis is a scourge in low-income countries, with 10.42% of deaths. HIV/AIDS infection has negatively contributed to these deaths during the study period. The search for comorbidities in any patient with tuberculosis should be systematic in order to improve their global management.


Assuntos
Antituberculosos/administração & dosagem , Infecções por HIV/epidemiologia , Tuberculose Pulmonar/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Coinfecção/epidemiologia , Feminino , Hospitais , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Níger/epidemiologia , Prevalência , Estudos Retrospectivos , Tuberculose/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico , Adulto Jovem
19.
J Assoc Physicians India ; 67(9): 27-29, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561684

RESUMO

Introduction: Hepatitis B (HBV) and Hepatitis C (HCV) are two common viral infections causing cirrhosis. Aim: The aim of this study was to find the seroprevalence of HBV and HCV along with occurrence of co-infection of HBV and HCV in patients attending a tertiary care hospital. Materials and Methods: The study was done for a period of one year (January to December 2016) in the Department of Microbiology, Medical College, Kolkata. After obtaining ethical clearance and informed consent from the patients, serum samples were collected from all patients referred to Department of Microbiology for antibody to HCV and Hepatitis B surface antigen (HBsAg) screening. ELISA was performed for anti HCV antibody and HBsAg. The results and relevant clinical information were noted and analysis was done. Results: A total of 10802 samples were received, of which 316 (2.92 %) were HBsAg positive, 115 (1.06%) were HCV antibody positive and a total of 7 (0.07%) patients were positive both for HBsAg and Anti HCV antibody. There was male preponderance. Anti HCV antibody was more common in age below 10 years and in thalassemia patients. Out of 7 patients positive for both, 5 patients were on regular blood transfusion due to beta thalassemia and 2 patients had history of chronic liver disease. Conclusion: In this study, it was found that there was seroprevalence of 2.92 % of HBsAg, 1.06% of HCV antibody and 0.07% positive both for HBsAg and HCV antibody among the patients of a tertiary care centre in Eastern India.


Assuntos
Coinfecção , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Índia/epidemiologia , Masculino , Estudos Soroepidemiológicos , Centros de Atenção Terciária
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 904-910, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484252

RESUMO

Objective: To analyze the etiologic and epidemiological characteristics of adult acute respiratory infections in Shanghai during 2015-2017. Methods: Data was collected from outpatients with acute respiratory infections who visited the Fever Clinics in three hospitals of different levels in three administrative regions of Shanghai, from 2015 to 2017. Basic information and nasopharyngeal swabs were collected from cases in line with the inclusion criteria. Multiplex RT-PCR and bacterial cultures were performed to detect the respiratory pathogens. Results: A total of 806 individuals were enrolled from 2015 to 2017. Respiratory pathogens were identified in 73.45% (592/806) of the cases, with the virus detection rate as 66.75% (538/806). It was found that the major respiratory pathogens for virus detection were influenza A in 326 (40.45%), influenza B in 116 (14.39%), rhinovirus/enterovirus in 39 (4.84%) of the cases. The overall detection rate of bacteria was 16.13% (130/806), including Klebsiella pneumoniae in 90 (11.17%) cases, Staphylococcus Aureus in 46 (5.71%) cases. Other kind of bacteria were not detected in our study. The detection rates on Mycoplasma pneumoniae was 5.33% (43/806) and on Chlamydia pneumonia was 0.37% (3/806). Co-infection with multiple pathogens was detected in 18.61% (150/806) of the cases, including 135 with double infection (accounting for 90.00%), 14 with triple infection and 1 with quadruple infection (accounted for 9.33% and 0.67%, respectively). Among the 150 cases with co-infections, the main identified pathogens were influenza A, Klebsiella pneumoniae, Staphylococcus aureus, and Mycoplasma pneumoniae. Pathogens of acute respiratory infections that identified among the outpatients from the Fever Clinics at different time, region or population, the characteristics were different (P<0.001). Conclusions: In 2015-2017, outpatients with acute respiratory infections in Shanghai were mainly caused by influenza virus or other viruses, however dynamically with its composition, time, region and characteristics of the population. It is necessary to strengthen and combine related medical and preventive services and to develop the appropriate strategies regarding clinical diagnosis and treatment.


Assuntos
Bactérias/isolamento & purificação , Infecções Bacterianas/diagnóstico , Influenza Humana/diagnóstico , Reação em Cadeia da Polimerase Multiplex/métodos , Nasofaringe , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Viroses/diagnóstico , Vírus/isolamento & purificação , Doença Aguda , Adulto , Bactérias/genética , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , China/epidemiologia , Coinfecção/diagnóstico , Enterovirus/genética , Enterovirus/isolamento & purificação , Monitoramento Epidemiológico , Humanos , Incidência , Vírus da Influenza A/genética , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/genética , Vírus da Influenza B/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Mycoplasma pneumoniae , Nasofaringe/microbiologia , Nasofaringe/virologia , Vigilância da População , Infecções Respiratórias/diagnóstico , Rhinovirus/genética , Rhinovirus/isolamento & purificação , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Viroses/epidemiologia , Viroses/virologia , Vírus/genética
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