Biomedical subjects
Publications and source records attributed to Gabriel Weber.
This report describes a case of granulomatous inflammation, involving the bone marrow and skin, due to Bartonella infection in an immunocompetent patient. The clinical presentation included prolonged fever, pancytopenia, rash and hepatitis. Bartonella infection should thus be added to the growing list of entities that produce marrow granulomas and fever.
The incidence of Pneumocystis Carinii pneumonia (PCP) may rise due to a more extensive use of immunosuppressive therapy. Information and guidelines in the last decade regarding prevention, diagnosis and treatment of the disease were based upon data collected in patients with Acquired Immuno Deficiency Syndrome (AIDS). However, scientific data regarding risk factors, clinical manifestations and treatment of PCP in patients without AIDS is accumulating. The major risk factors for acquiring PCP are hematological malignancies and treatment with immunosuppressive drugs, especially corticosteroids. The clinical course deteriorates more rapidly than in patients with AIDS and many patients have other opportunistic coinfections, especially with Cytomegalovirus and Candida. The duration of treatment may be shorter and drug tolerance is usually better than in patients with AIDS. However, mortality remains high even with appropriate treatment and necessitates a high index of suspicion and the use of empiric treatment even before a definitive diagnosis is made.