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At least 19 recordsLinked to original sources
PubMed1987

Tissue diagnosis of selected AIDS-related opportunistic infections.

Opportunistic infections are the most common initial manifestations of AIDS and, in many instances, are first encountered in surgical specimens. Pneumocystis carinii pneumonitis is by far the most frequent infection seen in biopsy specimens of AIDS patients. Most pathologists are familiar with its histopathologic presentations from previous experience. By contrast, many other opportunistic infections are either new or present clinically and pathologically in unfamiliar ways. Cytomegalovirus affects primarily the alimentary tract and lung. Colitis is the most common presentation. Penetrating ulcers may perforate. Most often, mesenchymal cells, endothelium in particular, show the typical intranuclear and intracytoplasmic inclusion bodies. The greater the number of inclusion bodies in tissues the shorter is the survival of the patient. Mycobacterium avium-intracellulare affects mainly small intestine and lymph nodes and produces a clinical and histologic picture similar to that of Whipple's disease. Diffuse infiltrates of histiocytes stuffed with acid-fast bacilli are characteristic. Cryptosporidiosis is the most ominous enteric opportunistic infection. Protozoa attach themselves to the epithelial surface and produce severe profuse, watery diarrhea. Cryptococcosis is seen in lung, lymph node, and brain biopsy specimens. Large numbers of organisms, sometimes with deficient mucinous capsules, and little or no inflammatory reaction, are notable. Toxoplasmosis is the most common cause of neurological complications in AIDS. Brain biopsy specimens show necrosis, microglial nodules, perivascular lymphocytic infiltrates, and, in 50% of cases, trophozoites.

Acquired Immunodeficiency Syndrome↗
PubMed1975

[Mechanisms which favor the development of opportunistic infections].

Opportunistic infections frequently occur in patients whose defense mechanisms are compromised. Some of the available defense mechanisms of the human organism are outlined, and the case is presented of a patient whose defense was weakened or destroyed, i.e. compromised by various mechanisms. It is important to recognize the increasing frequency of opportunistic infections inside and outside the hospital environment.

Adrenal Cortex Hormones↗
PubMed1994

Therapy of opportunistic infections.

Opportunistic infections are becoming really or apparently more frequent because of improved diagnostic techniques, increased age of the people in the developed world, better medical therapy, and higher number of patients living with transplanted organs and on immunosuppressive and glucocorticoid therapy, and also because of AIDS pandemic. Prevention of bacterial, fungal and viral infections includes classical preventive measures, surveillance, and education of patients and medical personnel. Vaccination is important especially to prevent viral diseases and also some bacterial ones. Routine antibiotic prophylaxis decreases some surgical infections. Meticulous follow-up of immunocompromised patients and specific anti-infective therapy saves the patients' lives in non-fatal diseases and prolongs the life in AIDS patients.

Anti-Bacterial Agents↗
PubMed2004

[Legionnaires' disease and HIV infection: an opportunistic infection?].

BACKGROUND AND OBJECTIVE: Legionella infections are not frequent in HIV-infected patients, although clinical manifestations and outcome are particularly severe in this subset. This manuscript analyzes the clinical features and immunological situation of HIV-infected patients with Legionnaires' disease (LD). PATIENTS AND METHOD: The clinical files of HIV-infected patients diagnosed with LD from 1983 to December 2003 were reviewed. The incidence of hospital-acquired Legionella pneumonia (HALP) from 1997-2000 in HIV-infected patients was compared with that of non infected patients. RESULTS: Eighteen patients were included. 72.2% were diagnosed by the Legionella urinary antigen assay. The incidence of HALP in HIV-infected and non infected patients was 0.3 and 0.25/1000 admissions/year, respectively (p = 0.42). 83.3% received appropriate antibiotic treatment at the Emergency department. The mean lymphocyte CD4 count was 348.1/microl, 53.8% had an undetectable viral load and 64.7% were on antiretroviral therapy. 72.2% were smokers, 38.8% had cancer and 16.7% were on chemotherapy. 93.8% had cough, 75% dyspnea, 62.5% extrarespiratory symptoms, 76.5% increased AST, 50% increased CK and 56.3% hyponatremia. Moreover, 50% developed bilateral pulmonary infiltrates, 83.3% respiratory failure and 22.2% died. CONCLUSIONS: Although LD is not more frequent in HIV-infected than in non infected patients, its clinical severity suggests that it is an opportunistic infection.

AIDS-Related Opportunistic Infections↗
PubMed1995

[A very up-to-date stage in the fate of infectious diseases: parasitic and fungal opportunistic infections].

Opportunistic parasitosis and mycosis are becoming ever more widespread, mainly under the influence of major immunodeficiencies, either acquired (AIDS) or therapeutic. In this general overview, their main aspects, both clinical and epidemiological, are underlined. In terms of epidemiology, three types of phenomena have been observed: 1) emergence of human parasitosis unknown before (microsporidiosis due to Enterocytozoon bieneusi, Encephalitozoom hellem or Septata intestinalis); 2) among the human parasites already known, identification of very pathogenic strains (Toxoplasma gondii, Aspergillus fumigatus, Cryptococcus neoformans); 3) origin probably or certainly nosocomial of certain infections (pneumocystosis; toxoplasmosis and visceral leishmaniasis transmitted during bone-marrow or organ transplantations). The development of deep mycosis (invasive aspergillosis) is particularly promoted by granulopenia and alterations in the phagocytosis. On the other hand, opportunistic protozoosis (toxoplasmosis and leishmaniasis) and helminthiasis (strongyloidosis due to Strongyloides stercolaris) are related, above all, to disorders in cellular immunity (deficit of CD4+, mainly). Finally, several of these infections may be characterised by a variety of clinical pictures and outcome, depending on the contributory factors (immunodeficit or not) which led to the development of the infection.

AIDS-Related Opportunistic Infections↗
PubMed1998

Kaposi's sarcoma in HIV infection: impact on opportunistic infections and survival.

OBJECTIVE: To determine the effect of Kaposi's sarcoma on survival of HIV-infected patients. METHODS: Retrospective cohort study to compare the survival of 241 HIV-infected homosexual patients with Kaposi's sarcoma (cases) with that of 241 HIV-infected homosexual patients without Kaposi's sarcoma (control subjects) but with a similar level of immunosuppression (measured by the absolute CD4+ lymphocyte count). RESULTS: Cases and control subjects were similar in age, occurrence of previous opportunistic infections, and the use of antiretroviral therapy. The mean CD4+ lymphocyte counts were similar for cases and control subjects (185 x 10(6) versus 184 x 10(6)/l, respectively). Cases had a higher incidence of opportunistic infections (5.95 versus 3.88 infections, respectively, per 100 person-months of observation) and a greater number of infections typical of late-stage HIV infection. Cases had a shorter overall survival than did control subjects (P=0.0025). Kaposi's sarcoma was associated with an increased risk of death (odds ratio, 1.28), even when adjusting for age, previous opportunistic infection, baseline CD4+ lymphocyte count, and antiretroviral therapy. CONCLUSION: Kaposi's sarcoma appears to accelerate the clinical course of HIV infection. Opportunistic infections develop earlier and more often in patients with the disease than in control subjects. Survival was significantly shorter in patients with Kaposi's sarcoma.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Parasite genotypically related to a monoxenous trypanosomatid of dog's flea causing opportunistic infection in an HIV positive patient.

An HIV positive patient presenting a clinical picture of visceral leishmaniasis co-infection was submitted to a bone marrow aspiration after admission to hospital. Amastigotes forms were seen in the bone marrow aspirate and the parasite grew in culture as promastigotes. Molecular analyses showed that the flagellates isolated did not belong to the genera Leishmania, Trypanosoma or Sauroleishmania. It was not possible to establish infection in laboratory animals. In vitro culture of mouse peritoneal macrophages revealed the invasion of the host cells by the flagellates and their killing 48 hr after infection. Opportunistic infection with an insect trypanosomatid was suspected. Further hybridization analyses against a panel of different monoxenous and heteroxenous trypanosomatids showed kDNA cross-homology with Leptomonas pulexsimulantis a trypanosomatid found in the dog's flea.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Therapeutic perspectives of HIV infection and of opportunistic infections. Multicenter projects of clinical investigation in the EEC].

Some centers in Portugal involved in the treatment of AIDS patients collaborate in clinical research programmes at a European level. The European Network for the Treatment of AIDS (ENTA) is a concerted action, with logistical and political support from the European Community. Four prospective European multicentre trials on opportunist infections in AIDS patients, have been implemented since the beginning of the ENTA, and 45 European centres, belonging to 11 countries, including Portugal, are so far involved in the present Trials in the Treatment and Prophylaxis of Tuberculosis and Toxoplasmosis. EUROAIDS is another concerted action whose aim is a retrospective study on opportunist infections and cancers related with AIDS registered in several countries in Europe, from 1979 to 1989, and correlate these data with demographic and clinical aspects. Another multicentric trial on antiretroviral treatment, The Iberian ddI study, started and several Spanish and Portuguese centres enrolled patients in this study.

European Union↗
PubMedDate not supplied

[Prevention and treatment of opportunistic infections].

An opportunist infection (OI) is understood to be an infection produced by microorganisms that invade a host with impaired immune capacity, such as children with HIV infection. The adequate treatment and chemoprophylaxis of these infections has improved the prognosis of their evolution, although they still present a high morbidity and mortality when they occur. In this sense, the introduction of triple therapy (new antiretroviral inhibitors and protease inhibitors) is likely to produce a prompt decrease in the incidence of OI because of the regression in the degree of immunosuppression that it induces. The degree of immunosuppression is determined by the number of CD4 lymphocytes, the most reliable marker for assessment. Normal CD4 lymphocytes values are different for each age group and have important connotations for the prophylactic measures to be used at each moment depending on the CD4 lymphocyte count. Opportunist infections influence the quality of life of patients. More than 100 microorganisms, including bacteria, viruses, fungi and protozoa, cause OI. This paper describes primary and secondary prophylaxis as well as the treatment of the most frequent opportunist infections (Pneumocystis carinii pneumonia, bacterial infections, Cryptococcus neoformans, Cytomegalovirus, Herpes simple, Varicella-zoster virus. Toxoplasmosis, Mycobacterium tuberculosis, M. avium-intracellulare, M. kansasii).

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Antibodies to the infective agents of opportunistic infections in blood of patients with hemoblastosis complicated with pneumonia].

The examination of 112 hematological patients with diagnosed acute and chronic leucosis, lymphoma, myeloma, anemia, melanoma and other diseases revealed not a single subject among these examinees in whom no markers of opportunistic infections were detected. Low titers of antibodies to Pneumocystis carinii, cytomegalovirus (CMV), Epstein-Barr virus (EBV) were noted in 42%, 46.4% and 40.2% of examinees, respectively. Markers of acute diseases, such as class IgM, IgG antibodies in high titers, as well as P.carinii, CMV, EBV antigens, were detected in 37.5%, 30.4% and 22.3% of patients of a hematological hospital. In the group of comparison (donors) these figures were, respectively, 15.3%, 2.4% and 6.9%. The signs of monoinfection were detected in 11.6% (pneumocystosis), in 10.7% (CMV infection) and in 14.3% (EBV infection), while the markers of two infections, EBV infection and pneumocystosis, were detected in 9.8%, EBV and CMV infections in 11.6%, pneumocystosis and CMV infection in 14.3%; mixed contamination with all three infective agents was detected in 12.5% of the patients.

Adolescent↗
PubMed1998

[Prevention of opportunistic infections in HIV-infected adults].

Opportunistic infections have a major influence on morbidity and mortality in HIV-infected individuals. Prophylactic measures have to be introduced for each patient, corresponding to the stage of disease measured by CD4-lymphocyte count. They consist of exposure prophylaxis, vaccinations and especially chemoprophylaxis with antimicrobials. Some live vaccines are contraindicated in HIV infected patients. Pneumococcal vaccine for every patient and specific primary prophylaxis against pneumocystis carinii pneumonitis, cerebral toxoplasmosis and M. avium infection in patients with manifest immunodeficiency improve survival and quality of life of many patients. After most opportunistic infections, secondary lifelong antimicrobial prophylaxis is indicated. In future, indications of primary and secondary prophylaxis have to be redefined in the light of the new antiretroviral combination therapies.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Severe opportunistic infections in AIDS patients with late-stage disease.

BACKGROUND: Clinicians caring for patients who have acquired immunodeficiency syndrome (AIDS) need to be aware of the wide variety of infectious diseases that can occur. Although Pneumocystis carinii pneumonia (PCP) is the most common AIDS-defining infection, other opportunistic infections associated with advanced immunodeficiency can develop after an initial diagnosis. METHODS: To ascertain AIDS-defining opportunistic infections that developed at the time of or after an AIDS diagnosis, and intensive chart review was conducted for 45 homosexual men with AIDS who died from 1990 through 1992. Time to death after first occurrence of these infections was also determined. RESULTS: The most common opportunistic infection occurring as the initial AIDS-defining illness was PCP (31 percent). The most common opportunistic infection occurring as a secondary disease was cytomegalovirus (CMV) disease (40 percent), followed by disseminated Mycobacterium avium complex (33 percent) and invasive candidiasis (31 percent). Each of these latter infections was associated with a poor prognosis (median time to death < or = 8 months). CONCLUSIONS: Diseases caused by CMV, disseminated M. avium complex, and invasive candidiasis were uncommon presenting manifestations of AIDS but were common secondary diseases that tended to be associated with limited survival. With increasing survival and a declining incidence of PCP as a result of medical therapy, other severe opportunistic infections might become increasingly recognized.

AIDS-Related Opportunistic Infections↗