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jiroveci and hiv

Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
Xia Lin, Shikha Garg, Christine L Mattson, Qingwei Luo, Jacek Skarbinski
The US treatment guidelines recommend Pneumocystis jiroveci pneumonia (PCP) prophylaxis for all HIV-infected persons with a CD4 count <200 cells/mm(3) (ie, eligible for PCP prophylaxis). However, some studies suggest PCP prophylaxis may be unnecessary in virally suppressed patients. Using national data of HIV-infected adults receiving medical care in the United States during 2009 to 2012, the authors assessed the weighted percentage of eligible patients who were prescribed PCP prophylaxis and the independent association between PCP prophylaxis prescription and viral suppression...
September 14, 2016: Journal of the International Association of Providers of AIDS Care
Kate Buchacz, Bryan Lau, Yuezhou Jing, Ronald Bosch, Alison G Abraham, M John Gill, Michael J Silverberg, James J Goedert, Timothy R Sterling, Keri N Althoff, Jeffrey N Martin, Greer Burkholder, Neel Gandhi, Hasina Samji, Pragna Patel, Anita Rachlis, Jennifer E Thorne, Sonia Napravnik, Keith Henry, Angel Mayor, Kelly Gebo, Stephen J Gange, Richard D Moore, John T Brooks
BACKGROUND: There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in care in the United States and Canada. METHODS: We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 2000-2010. After excluding 16 737 (21%) with any AIDS-defining clinical events documented before NA-ACCORD enrollment, we analyzed incident OIs among the remaining 63 541 persons, most of whom received antiretroviral therapy during the observation...
September 15, 2016: Journal of Infectious Diseases
Naporn Khamanarong, Somchai Insiripong
The CD4 lymphocytes are an important part of the immune system. Besides HIV Infection, other conditions can cause a low CD4 count. We report the case of a 82-year-old female who presented with a markedly low CD4 count during a severe lower respiratory tract infection and respiratory failure without HIV infection. The total lymphocyte and the absolute CD4 counts are 255/mm³ and 109/mm³, respectively. Sputum and bronchial lavage fluid were both negative for acid-fast bacilli. The anti-HIV antibody test was negative...
May 2016: Southeast Asian Journal of Tropical Medicine and Public Health
Vidya Sanjay Nagar, Rahul Kadu, Shamshersingh Gajendra Chauhan, Rudrarpan Chatterjee, Aniruddha Kaushik, Deniskumar Vashrambhai Patel, Ankita Sood
idiopathic CD4(+) lymphocytopenia (ICL) is a rare disorder characterized by the presence of depleted CD4 cell line without the presence of HIV infection. Slight male preponderance is noticed and is usually seen in the middle age group. Opportunistic infections are the reason for their discovery and here we describe a case where a man was diagnosed as having Pneumocystis jiroveci pneumonia and oral candidiasis.
June 2016: Indian Journal of Critical Care Medicine
Megan Curtis, Anish Patel, Kyle Degeyter, Harold Neitzschman
A 36-year-old woman with past medical history of HIV/AIDS not on HAART therapy (CD4 count of 34) and recurrent Pneumocystis jiroveci pneumonia presented to the emergency room for cough, chest pain, and worsening shortness of breath over the past 72 hours.
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Nasir Saleem, Sanober Parveen, Chibuzo Odigwe, Nkemakolam Iroegbu
Pneumomediastinum, the presence of free air within the mediastinal cavity, is sometimes accompanied by subcutaneous emphysema and pneumorrhachis (air within the spinal canal). We report the case of a 28-year-old man with previously undiagnosed HIV who was diagnosed with extensive pneumomediastinum, pneumorrhachis, and subcutaneous emphysema secondary to Pneumocystis jiroveci pneumonia after presenting with chest pain, dyspnea, and central cyanosis. Surgical consultation was requested, but a conservative approach of observation proved sufficient as the free air was resorbed into the surrounding tissues...
April 2016: Proceedings of the Baylor University Medical Center
Lara E Coelho, Sandra W Cardoso, Rodrigo T Amancio, Ronaldo I Moreira, Sayonara R Ribeiro, Alessandra B Coelho, Dayse P Campos, Valdiléa G Veloso, Beatriz Grinsztejn, Paula M Luz
BACKGROUND: Opportunistic illnesses still account for a huge proportion of hospitalizations and deaths among HIV-infected patients in the post combination antiretroviral therapy (cART) era, particularly in middle- and low-income countries. The aim of this study was to assess predictors of the top four most incident opportunistic illnesses (tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jiroveci pneumonia) in an HIV clinical cohort from a middle-income country in the post cART era...
2016: BMC Infectious Diseases
L I Wang, Hao Liang, L I Ye, Junjun Jiang, Bingyu Liang, Jiegang Huang
The present study aimed to evaluate the effects of adjunctive corticosteroid treatment on Pneumocystis jiroveci pneumonia in patients with human immunodeficiency virus (HIV). A literature search of relevant randomized controlled trials (RCTs) published prior to March 2014 was performed using a number of websites, including PubMed, EMbase and Ovid, using the following keywords: Corticosteroids, glucocorticoide, cortisol, corticosterone, HIV/acquired immunodeficiency syndrome, P. jiroveci pneumonia, and PCP. All RCTs investigating the use of adjunctive corticosteroids for the treatment of P...
February 2016: Experimental and Therapeutic Medicine
P Fillâtre, M Revest, S Belaz, F Robert-Gangneux, J-R Zahar, F Roblot, P Tattevin
Pneumocystis jiroveci (formerly P. carinii) is an opportunistic fungus responsible for pneumonia in immunocompromised patients. Pneumocystosis in non-HIV-infected patients differs from AIDS-associated pneumocystosis in mostly two aspects: diagnosis is more difficult, and prognosis is worse. Hence, efforts should be made to target immunocompromised patients at higher risk of pneumocystosis, so that they are prescribed long-term, low-dose, trimethoprime-sulfamethoxazole, highly effective for pneumocystosis prophylaxis...
May 2016: La Revue de Médecine Interne
Henry Masur
The incidence of HIV-related opportunistic infections (OIs) has declined in the United States with the increasing use of effective antiretroviral therapy for the treatment of HIV infection. However, the absolute number of patients with OIs remains high and there continues to be considerable associated mortality. OI guidelines from the National Institutes of Health, Centers for Disease Control and Prevention, and Infectious Diseases Society of America continue to be updated on a regular basis, several times per year, as optimal strategies for prevention and therapy evolve...
August 2015: Topics in Antiviral Medicine
Miguel J Martínez, Sergio Massora, Inácio Mandomando, Esperança Ussene, Dercio Jordao, Lucilia Lovane, Carmen Muñoz-Almagro, Paola Castillo, Alfredo Mayor, Cristina Rodriguez, Miriam Lopez-Villanueva, Mamudo R Ismail, Carla Carrilho, Cesaltina Lorenzoni, Marcus V G Lacerda, Quique Bassat, Clara Menéndez, Jaume Ordi, Jordi Vila
In developing countries, the knowledge of the microorganisms causing fatal infections is critical and could help designing and implementing more effective preventive interventions and treatment guidelines. We aimed to develop and validate protocols for microbiological analysis in post-mortem samples obtained during minimally invasive autopsy (MIA) procedures and to assess their performance. Thirty MIAs performed in adults at Maputo Central Hospital in Southern Mozambique were included in the analysis. Microbiological tests included a universal screening for HIV, hepatitis B and C viruses, Plasmodium falciparum, and bacterial/fungal culture...
January 2016: Diagnostic Microbiology and Infectious Disease
Poojary Indira, Papanna Mohan Kumar, Shenoy Shalini, Kulkarni Vaman
BACKGROUND: HIV/AIDS and Diabetes Mellitus are the diseases' known to supress cell mediated immunity and predispose patients for opportunistic infections. Hence, we conducted a study to compare the common opportunistic infections (OIs) between People Living with HIV with DM (PLHIV-DM) and PLHIV without DM (PLHIV). METHODOLOGY: PLHIV with DM and without DM (1:1) were prospectively included in the study from January 2011 to January 2012 at a tertiary care hospital in Mangalore city...
2015: PloS One
Carlos Valdebenito, Macarena Bonacic, Jennifer Matamala, Marcelo Wolff
We report a case of a middle-age male patient, with newly HIV infection in AIDS stage diagnosis, no comorbitidies, who was hospitalized for subacute malaise, fever, self-limited unproductive cough and no bloody chronic diarrea. The diagnosis of Pneumocystis jiroveci pneumonia was performed by imagenological suspicion and stains of cysts of this pathogen with bronchoalveolar lavage samples. Treatment was initiated with oral cotrimoxazole and starting HAART with good clinical outcome. Concomitantly, an etiologic study was conducted for chronic diarrhea and through histopathological examination of colonic mucosa, numerous extracellular cystic structures Pneumocystis characteristics were observed, performing the diagnosis of extrapulmonary pneumocystosis...
June 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Ho Namkoong, Hiroshi Fujiwara, Makoto Ishii, Kazuma Yagi, Mizuha Haraguchi, Masako Matsusaka, Shoji Suzuki, Takanori Asakura, Takahiro Asami, Fumitake Saito, Koichi Fukunaga, Sadatomo Tasaka, Tomoko Betsuyaku, Naoki Hasegawa
BACKGROUND: In human immunodeficiency virus (HIV)-infected patients, immune reconstitution inflammatory syndrome (IRIS) due to nontuberculous mycobacteria (NTM) infection is one of the most difficult types of IRIS to manage. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been suggested as a useful tool for evaluating the inflammatory status of HIV-infected patients. We present the first case of Mycobacterium avium complex (MAC)-associated IRIS (MAC-IRIS) that was successfully followed up using 18F-FDG PET/CT...
2015: BMC Medical Imaging
Ravinder Kaur, Anupriya Wadhwa, Preena Bhalla, Megh Singh Dhakad
HIV has become a major health problem in India, patients commonly succumb to opportunistic infections (OIs), respiratory infections being an important cause of morbidity and their accurate diagnosis is still a challenge. Our aim was to study the occurrence of Pneumocystis pneumonia (PCP) in HIV/AIDS patients with respiratory complaints attending ART clinic and to compare various diagnostic methodologies. One hundred and twenty five HIV/AIDS patients presenting with respiratory symptoms like cough, fever, breathlessness etc, were enrolled, and induced sputum samples were collected...
August 2015: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Michael L Krol, Varsha Podduturi, Abdulla Majid-Moosa, John R Krause, Adan Mora
AIDS-related malignancies may alter clinical courses and result in death in critically ill patients. We present a case of a newly diagnosed AIDS patient with Pneumocystis jiroveci pneumonia, Epstein-Barr virus, and cytomegalovirus infections who was found to have widely metastatic kinase-negative anaplastic large-cell lymphoma. This case demonstrates the diversity in the malignant presentation of HIV-infected patients, outside of the more commonly observed non-Hodgkin lymphomas.
July 2015: Proceedings of the Baylor University Medical Center
Benjamin T Schleenvoigt, Ralf Ignatius, Michael Baier, Thomas Schneider, Marko Weber, Stefan Hagel, Christina Forstner, Mathias W Pletz
CASE PRESENTATION: Here, we report on a case of VL in an HIV-infected patient from the Republic of Georgia who had moved to Germany 14 years before and who had travelled several times to southern Europe in between. After presenting with typical Pneumocystis jiroveci pneumonia, which was treated appropriately, the patient was started on antiretroviral therapy. Shortly thereafter, however, he developed fever of unknown origin. All laboratory assays for the diagnosis of various infectious agents including serological assays and polymerase chain reaction testing of bone marrow aspirate to diagnose VL did not yield positive results at first...
February 2016: Infection
Alejandro Rey, Cecilia Losada, Julieta Santillán, Fernando Fiorentini, María Schiaffino, Héctor J Peroni, Diego Giunta, Laura Barcán, Gabriel Waisman
BACKGROUND: Respiratory infection caused by Pneumocystis jiroveci is a common opportunistic infection in patients with human immunodeficiency virus (HIV) with CD4 counts < 200 cells/mm(3). However, it has also been reported in patients with other causes of immunosuppression. OBJECTIVES: To compare the characteristics, severity and mortality of respiratory infection by P. jiroveci in patients with and without HIV infection. METHODS: Retrospective cohort follow-up of adult patients admitted to our hospital with infection by P...
April 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
J Lam, M M Kelly, R Leigh, M D Parkins
Pneumocystis jiroveci pneumonia (PJP) opportunistically targets immunosuppressed patients, most notably those with advanced HIV/AIDS. Radiologically, PJP typically appears as bilateral diffuse pulmonary infiltrates. Herein an unusual case of an immunocompetent woman developing granulomatous PJP in the absence of evident risk factors is described. PJP may be an under-recognized cause of pulmonary nodules in immune competent individuals.
2014: Respiratory Medicine Case Reports
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