RESUMO
Tuberculosis and human immunodeficiency virus (HIV) infection are two important linked public health problems in the world of today. Tuberculosis in HIV infected patients is frequently atypical in its clinical and radiological findings and commonly has an extrapulmonary dissemination. Atypical mycobacteriosis have also been reported in patients with HIV infection. We review here all the patients admitted from 1986 to 1991 with definitive diagnosis of tuberculosis and HIV infection at the National Institute of Respiratory Diseases in Mexico City. Out of 220 patients with HIV infection and pulmonary complications, 19 had proven tuberculosis. Their mean age was 34 +/- 8 years and seven were homosexual males. In 16 patients (84%), respiratory symptoms (cough with sputum) and fever were the first manifestations of the HIV infection. Only two patients had the typical cavitary lesions but also coexisting with miliary tuberculosis. The rest had several types of non cavitated pulmonary opacities or other thoracic or pleural alterations. Eleven patients (58%) had, in addition, extrapulmonary tuberculosis. Mycobacterium tuberculosis was cultured in 11 of 12 patients but no atypical mycobacteria were isolated. Only seven of the 19 patients completed at least six months of treatment and two of them relapsed. Three patients died in their first admission; the rest were lost in the follow up. Our results show that the clinical features of tuberculosis associated to HIV infection are similar to those described in other countries.
Assuntos
Infecções por HIV/complicações , Tuberculose/complicações , Adulto , Feminino , Humanos , Masculino , Tuberculose/diagnósticoAssuntos
Histoplasmose/diagnóstico , Pneumopatias Fúngicas/diagnóstico , Síndrome da Imunodeficiência Adquirida/complicações , Doença Aguda , Adulto , Feminino , Histoplasmose/complicações , Histoplasmose/diagnóstico por imagem , Humanos , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos RetrospectivosRESUMO
Measles pneumonia is the most frequent complications associated with mortality in this infection. There are two types, one corresponds to the giant-cells pneumonia and the other one to lung superinfection after measles infection. The first one has been occurred in immunosuppressed patients, without rash. We reported a measles pneumonia case in a previously healthy adolescent girl who had a fatal pneumonia by giant cells demonstrated by open lung biopsy. The review of the literature showed that this is very unusual in normal population.
Assuntos
Células Gigantes/patologia , Pulmão/patologia , Sarampo/complicações , Pneumonia/etiologia , Adolescente , Feminino , Humanos , Tolerância Imunológica , Pneumonia/patologiaRESUMO
We describe a case of polimicrobial endocarditis in a patient with congenital aortic stenosis and end-stage renal failure in treatment with steroids and chronic haemodialisis. The blood culture grew e.coli, enterobacter sp, and s.epidermidis. Only a few papers in the literature have been devoted to this entity. Its frequency seems to be progressively higher. The present case is a good example to talk about the predisponent factors. The review of literature has shown that the occurrence of this entity is specially high among addicts, the most frequent bacteria are s.aureus, streptococci and pseudomonas and the mortality can be as high as 80%.
Assuntos
Endocardite Bacteriana/etiologia , Infecções por Enterobacteriaceae , Infecções por Escherichia coli , Infecções Estafilocócicas , Adulto , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/congênito , Endocardite Bacteriana/microbiologia , Enterobacter/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Humanos , Falência Renal Crônica/complicações , Masculino , Infecções Estafilocócicas/microbiologia , Staphylococcus/isolamento & purificaçãoRESUMO
BACKGROUND: Several opportunistic intraocular infections have been described in patients with the human immunodeficiency virus, among them infections caused by Mycobacterium tuberculosis. In most cases, the diagnosis is based on clinical findings. Recent reports have described the usefulness of polymerase chain reaction techniques in the diagnosis of bacterial infections. METHODS: The authors observed a 29-year-old woman with acquired immune deficiency syndrome in whom unilateral chorioretinitis developed. The chorioretinitis appeared after cessation of treatment for pulmonary tuberculosis. We obtained aqueous humor by paracentesis and tested it by polymerase chain reaction to detect M. tuberculosis DNA. RESULTS: The polymerase chain reaction of the aqueous humor was positive for M. tuberculosis DNA. CONCLUSION: Polymerase chain reaction was useful in identifying M. tuberculosis in aqueous from a patient with chorioretinitis, pulmonary tuberculosis, and acquired immune deficiency syndrome.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Coriorretinite/microbiologia , Infecções Oculares Bacterianas/etiologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/complicações , Adulto , Humor Aquoso/microbiologia , Coriorretinite/patologia , DNA Bacteriano/análise , Eletroforese em Gel de Ágar , Infecções Oculares Bacterianas/patologia , Feminino , Fundo de Olho , Humanos , Reação em Cadeia da PolimeraseAssuntos
Infecção Hospitalar/prevenção & controle , Hospitais Públicos/organização & administração , Hospitais Especializados/organização & administração , Hospitais Estaduais/organização & administração , Vigilância da População , Infecção Hospitalar/epidemiologia , Hospitais Especializados/economia , Hospitais Estaduais/economia , Humanos , México , Estudos ProspectivosRESUMO
Se revisa la experiencia de 4 anos en artritis septica en el Instituto Nacional de la Nutricion y se presentan 24 pacientes, 80% de ellos inmunosuprimidos. En 42% de los casos la causa fue estafilicoco, y en el mismo porcentaje bacterias Gram negativas. Dentro de este grupo el germen mas frecuente fue salmonella, la cual se aislo en seis de nueve pacientes. El retraso en el inicio de antibioticos y puncion articular hizo necesaria la cirugia y se acompano de un pobre pronostico. El presente trabajo demuestra la alta incidencia de artritis septica por salmonella en pacientes inmunosuprimidos, y confirma la necesidad de un tratamiento medico temprano en pacientes con artritis septica
Assuntos
Adulto , Humanos , Masculino , Feminino , Artrite Infecciosa , Terapia de Imunossupressão , Infecções por Salmonella , Antibacterianos , PunçõesRESUMO
Se presentan los casos clinicos de tres mujeres en la sexta decada de la vida que acudieron a nuestro hospital por presentar un padecimiento multisistemico, semejante a lupus eritematoso generalizado, y caracterizado por una evolucion rapidamente progresiva que las llevo a la muerte por insuficiencia respiratoria. En vida fueron sometidas a biopsia pulmonar, la que demostro mediante tinciones especiales fibrosis intersticial y neumonitis descamativa, que ante la falta de antecedentes y/ o examenes de laboratorio se catalogo como idiopatica. Las tres pacientes recibieron esteroides como tratamiento, sin respuesta adecuada. Es posible que dentro del grupo de pacientes con fibrosis pulmonar idiopatica haya un subgrupo de curso acelerado, refractario al tratamiento, com manifestaciones extrapulmonares preponderantes y pronostico sombrio
Assuntos
Pessoa de Meia-Idade , Humanos , Feminino , Lúpus Eritematoso Sistêmico , Fibrose Pulmonar , Insuficiência RespiratóriaRESUMO
Se reviso la experiencia del Instituto Nacional de la Nutricion Salvador Zubiran en mucormicosis acumulada en los ultimos 20 anos. Se analizan fundamentalmente las caracteristicas clinicas y se hace hincapie en el tratamiento oportuno con el uso de anfotericina B y cirugia radical en base a un diagnostico temprano, el cual requiere un alto indice de sospecha