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https://www.readbyqxmd.com/read/28806010/blastomycosis-and-histoplasmosis-in-a-patient-with-glioblastoma-receiving-temozolomide
#1
Aiham H Jbeli, John Yu
Malignant glioblastoma multiform (GBM) is the most common primary malignancy of the brain in the U.S. Temozolomide (TMZ) is the cornerstone of management along with surgical resection and radiotherapy. Because of the reduction in the CD4+ lymphocyte count as a side effect of TMZ use, this patient population is under risk for opportunistic infections like Pneumocystis jiroveci. A male patient with newly diagnosed glioblastoma multiform presented with non-productive cough and chest pain. Before presentation, the patient received the standard therapy including surgical resection, radiation and TMZ...
October 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28803505/extracorporeal-membrane-oxygenation-in-an-hiv-positive-man-with-severe-acute-respiratory-distress-syndrome-secondary-to-pneumocystis-and-cytomegalovirus-pneumonia
#2
Deirdre Morley, Almida Lynam, Edmund Carton, Ignacio Martin-Loeches, Gerard Sheehan, Niamh Lynn, Serena O'Brien, Fiona Mulcahy
The management of critically ill human immunodeficiency virus (HIV)-positive patients is challenging; however, intensive care unit-related mortality has declined significantly in recent years. There are 10 case reports in the literature of extracorporeal membrane oxygenation (ECMO) use in HIV-positive patients, of whom seven survived to hospital discharge. We describe a 33-year-old Brazilian man who presented with Pneumocystis jirovecii pneumonia and severe hypoxic respiratory failure. He developed refractory acute respiratory distress syndrome (ARDS) and was commenced on veno-venous ECMO...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28797489/approach-to-fungal-infections-in-human-immunodeficiency-virus-infected-individuals-pneumocystis-and-beyond
#3
REVIEW
Richard J Wang, Robert F Miller, Laurence Huang
Many fungi cause pulmonary disease in patients with human immunodeficiency virus (HIV) infection. Pathogens include Pneumocystis jirovecii, Cryptococcus neoformans, Aspergillus spp, Histoplasma capsulatum, Coccidioides spp, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Talaromyces marneffei, and Emmonsia spp. Because symptoms are frequently nonspecific, a high index of suspicion for fungal infection is required for diagnosis. Clinical manifestations of fungal infection in HIV-infected patients frequently depend on the degree of immunosuppression and the CD4(+) helper T cell count...
September 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28793312/delays-in-hiv-diagnosis-and-associated-factors-among-patients-presenting-with-advanced-disease-at-a-tertiary-care-hospital-in-beijing-china
#4
Jing Xie, Evelyn Hsieh, Meng-Qing Sun, Huan-Ling Wang, Wei Lv, Hong-Wei Fan, Tai-Sheng Li
Delayed diagnosis of HIV infection is associated with advanced immunosuppression and increased risk of onward transmission. Little data exists regarding factors associated with diagnostic delays among patients presenting with advanced HIV disease in China. Medical records of patients with HIV/AIDS hospitalized at a 2000-bed tertiary hospital in Beijing, China between 1997 and 2012 were retrospectively reviewed. Demographic and clinical data of patients newly diagnosed with HIV at the hospital were abstracted...
2017: PloS One
https://www.readbyqxmd.com/read/28791509/feasibility-of-dose-dense-epirubicin-and-cyclophosphamide-with-subcutaneous-pegfilgrastim-3-6%C3%A2-mg-support-a-single-center-prospective-study-in-japan
#5
Sachi Morita, Toyone Kikumori, Nobuyuki Tsunoda, Takahiro Inaishi, Yayoi Adachi, Akiko Ota, Masahiro Shibata, Ayumu Matsuoka, Kenichi Nakanishi, Dai Takeuchi, Takefumi Mizutani, Tomoya Shimokata, Hironori Hayashi, Osamu Maeda, Yuichi Ando
BACKGROUND: Dose-dense chemotherapy consisting of a combination of epirubicin and cyclophosphamide (EC) improves the survival of patients with breast cancer. Although pegfilgrastim was used at a subcutaneous dose of 6.0 mg in a pivotal study of dose-dense EC treatment, pegfilgrastim at a dose of 3.6 mg has been approved in Japan. We have assessed the feasibility of dose-dense EC treatment supported with a 3.6 mg dose of pegfilgrastim by evaluating the relative dose intensity (RDI) and safety of the treatment, together with measuring the pegfilgrastim concentrations remaining on the day of starting the next cycle of chemotherapy...
August 8, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28791279/pneumocystis-jirovecii-pneumonia-in-pediatric-inflammatory-bowel-disease-a-case-report-and-literature-review
#6
Sally J Lawrence, Manish Sadarangani, Kevan Jacobson
Immunosuppressive therapy is a known risk factor for opportunistic infections. We report the first case of severe Pneumocystis jirovecii infection requiring intensive care in a pediatric patient with inflammatory bowel disease (IBD). The literature was reviewed and there were 92 reported cases of Pneumocystis pneumonia (PCP) in patients with IBD. Most sources were case reports and there was likely reporting bias toward patients receiving immunomodulators, anti-tumor necrosis factor (anti-TNF) therapy, and those who died...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28782390/treatment-of-pneumocystis-jirovecii-pneumonia-in-hiv-infected-patients-a-review
#7
Yu-Shan Huang, Jen-Jia Yang, Nan-Yao Lee, Guan-Jhou Chen, Wen-Chien Ko, Hsin-Yun Sun, Chien-Ching Hung
Pneumocystis pneumonia is a potentially life-threatening pulmonary infection that occurs in immunocompromised individuals and HIV-infected patients with a low CD4 cell count. Trimethoprim-sulfamethoxazole has been used as the first-line agent for treatment, but mutations within dihydropteroate synthase gene render potential resistance to sulfamide. Despite advances of combination antiretroviral therapy (cART), Pneumocystis pneumonia continues to occur in HIV-infected patients with late presentation for cART or virological and immunological failure after receiving cART...
August 5, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28781310/severe-thrombocytopenia-during-dolutegravir-containing-antiretroviral-therapy
#8
Kazuhiko Nakaharai, Makiko Miyajima, Hiroaki Kobayashi, Akihiro Shimizu, Yumiko Hosaka, Tetsuya Horino, Seiji Hori
A 56-year-old Japanese man diagnosed with acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia and cytomegalovirus infection presented with thrombocytopenia after starting antiretroviral therapy, which included dolutegravir (DTG). Although good control of the human immunodeficiency virus and cytomegalovirus infections was achieved, the patient's thrombocytopenia persisted. The patient's platelet count decreased to ≤50,000 /μL even after the cessation of valganciclovir, which can cause bone marrow suppression...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28779879/low-dose-trimethoprim-sulfamethoxazole-treatment-for-pneumocystis-pneumonia-in-non-human-immunodeficiency-virus-infected-immunocompromised-patients-a-single-center-retrospective-observational-cohort-study
#9
Kei Nakashima, Masahiro Aoshima, Tamao Nakashita, Masahiko Hara, Ayumu Otsuki, Satoshi Noma, Masafumi Misawa, Yoshihito Otsuka, Shinji Motojima
BACKGROUND/PURPOSE: The efficacy of low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be acceptable for the treatment of pneumocystis pneumonia (PCP) in non-human immunodeficiency virus (HIV)-infected patients, with a low incidence of adverse reactions. This study is aimed to evaluate the efficacy and safety of such a regimen for the treatment of non-HIV PCP. METHODS: We retrospectively enrolled 24 consecutive patients diagnosed with non-HIV PCP who were treated with low-dose TMP-SMX (TMP, 4-10 mg/kg/day; SMX, 20-50 mg/kg/day)...
July 23, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28774701/fungal-infections-in-hiv-aids
#10
REVIEW
Andrew H Limper, Antoine Adenis, Thuy Le, Thomas S Harrison
Fungi are major contributors to the opportunistic infections that affect patients with HIV/AIDS. Systemic infections are mainly with Pneumocystis jirovecii (pneumocystosis), Cryptococcus neoformans (cryptococcosis), Histoplasma capsulatum (histoplasmosis), and Talaromyces (Penicillium) marneffei (talaromycosis). The incidence of systemic fungal infections has decreased in people with HIV in high-income countries because of the widespread availability of antiretroviral drugs and early testing for HIV. However, in many areas with high HIV prevalence, patients present to care with advanced HIV infection and with a low CD4 cell count or re-present with persistent low CD4 cell counts because of poor adherence, resistance to antiretroviral drugs, or both...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28774170/an-autopsy-case-of-epstein-barr-virus%C3%A2-associated-diffuse-large-b-cell-lymphoma-of-the-central-nervous-system-in-an-immunocompromised-host
#11
Sun-Young Park, Seong Ik Kim, Hannah Kim, Yoojin Lee, Sung-Hye Park
Lymphomas arising in the central nervous system (CNS) of immunocompromised hosts represent non-Hodgkin's lymphomas exclusively associated with Epstein-Barr virus (EBV). Here we report an autopsy case of EBV-associated CNS diffuse large B-cell lymphoma (DLBCL) in a host suffering from systemic lupus erythematosus who underwent immunosuppressive therapy. After autopsy, EBV-associated CNS DLBCL as well as pulmonary mixed aspergillosis and Pneumocystis jirovecii pneumonia were added to the clinical impressions of complicated pneumonia and cerebral hemorrhage in this immunocompromised patient...
August 4, 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28771054/unexpected-pneumocystis-jirovecii-pneumonia-in-patients-with-untreated-chronic-lymphocytic-leukemia
#12
Lucile Sesé, Elisabeth Rivaud, Camille Bron, Véronique Leblond, Emmanuel Raffoux, Elisabeth Longchampt, Pierre Cahen, Leila Zemoura, François Mellot, Louis-Jean Couderc, Emilie Catherinot
No abstract text is available yet for this article.
August 3, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28770187/t-cell-lymphopenia-detected-by-newborn-screening-in-two-siblings-with-an-xq13-1-duplication
#13
Xavier Rios, Ivan K Chinn, Jordan S Orange, Celine I Hanson, Nicholas L Rider
Newborn screening for severe combined immunodeficiency has proven successful in identifying infants with T-cell deficiencies before they become severely ill. Additionally, the newborn screen can detect subtle early phenotypes that may become severe later in life. We present the case of siblings with features suggestive of T-cell lymphopenia identified as having low T-cell receptor excision circles counts by newborn screening. Expanded immune testing showed robust lymphocyte mitogen and antigen responses with normal vaccine responses and immunoglobulin levels for both boys over time...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28770116/cisplatin-induced-nephrotoxicity-and-hiv-associated-nephropathy-mimickers-of-myeloma-like-cast-nephropathy
#14
Muhammad Siddique Khurram, Ahmed Alrajjal, Warda Ibrar, Jacob Edens, Umer Sheikh, Ameer Hamza, Hong Qu
Myeloma cast nephropathy is an obstructing disorder of renal tubules, caused by precipitation of Bence Jones proteins. Myeloma-like cast nephropathy (MLCN) has been reported in the literature to occur in various primary renal and nonrenal diseases. We present a series of three rare cases of cast nephropathy, two of which are HIV patients, and the third patient is receiving cisplatin-based chemotherapy. However, in all three patients plasma cell dyscrasia has been ruled out. A 30-year-old male was admitted to the hospital with facial cellulitis...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28760906/mechanisms-of-action-of-vitamin-d-as-supplemental-therapy-for-pneumocystis-pneumonia
#15
Guang-Sheng Lei, Chen Zhang, Bi-Hua Cheng, Chao-Hung Lee
The combination of trimethoprim and sulfamethoxazole (TMP-SMX) is the most effective regimen for therapy of Pneumocystis pneumonia (PcP). As many patients with PcP are allergic or do not respond to it, efforts have been devoted to develop alternative therapies for PcP. We have found that the combination of vitamin D3 (VitD3; 300 IU/kg/day) and PMQ (5 mg/kg/day) was as effective as TMP-SMX for therapy of PcP. In this study, we investigated the mechanisms by which vitamin D enhances the efficacy of PMQ. C57BL/6 mice were immunosuppressed by CD4(+) cell depletion, infected with P...
July 31, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28759746/serum-markers-as-an-aid-in-the-diagnosis-of-pulmonary-fungal-infections-in-aids-patients
#16
Ana Isabela Passos, Rachel Polo Dertkigil, Marcelo de Carvalho Ramos, Ariane BussoLopes, Cibele Tararan, Erivan Olinda Ribeiro, Angélica Zaninelli Schreiber, Plinio Trabasso, Mariangela Ribeiro Resende, Maria Luiza Moretti
INTRODUCTION: The etiology of pulmonary infections in HIV patients is determined by several variables including geographic region and availability of antiretroviral therapy. MATERIALS AND METHODS: A cross-sectional prospective study was conducted from 2012 to 2016 to evaluate the occurrence of pulmonary fungal infection in HIV-patients hospitalized due to pulmonary infections. Patients' serums were tested for (1-3)-β-D-Glugan (BG), galactomannan, and lactate dehydrogenase (LDH)...
July 28, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28746178/assessment-of-cytomegalovirus-and-cell-mediated-immunity-for-predicting-outcomes-in-non-hiv-infected-patients-with-pneumocystis-jirovecii-pneumonia
#17
COMPARATIVE STUDY
Taeeun Kim, Se Yoon Park, Hyun-Jung Lee, Sun-Mi Kim, Heungsup Sung, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
The clinical importance of pulmonary cytomegalovirus (CMV) co-infection in patients with Pneumocystis jirovecii pneumonia (PCP) is uncertain. We therefore determined the association of CMV infection with outcomes in non-HIV-infected patients with PCP by assessing CMV viral load and CMV-specific T-cell response.We prospectively enrolled all non-HIV-infected patients with confirmed PCP, over a 2-year period. Real-time polymerase chain reaction from bronchoalveolar lavage was performed to measure CMV viral load, and CMV enzyme-linked immunospot assays of peripheral blood were used to measure CMV-specific T-cell responses...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28726611/added-value-of-next-generation-sequencing-for-multilocus-sequence-typing-analysis-of-a-pneumocystis-jirovecii-pneumonia-outbreak1
#18
Elena Charpentier, Cécile Garnaud, Claire Wintenberger, Sébastien Bailly, Jean-Benjamin Murat, John Rendu, Patricia Pavese, Thibault Drouet, Caroline Augier, Paolo Malvezzi, Anne Thiébaut-Bertrand, Marie-Reine Mallaret, Olivier Epaulard, Muriel Cornet, Sylvie Larrat, Danièle Maubon
Pneumocystis jirovecii is a major threat for immunocompromised patients, and clusters of pneumocystis pneumonia (PCP) have been increasingly described in transplant units during the past decade. Exploring an outbreak transmission network requires complementary spatiotemporal and strain-typing approaches. We analyzed a PCP outbreak and demonstrated the added value of next-generation sequencing (NGS) for the multilocus sequence typing (MLST) study of P. jirovecii strains. Thirty-two PCP patients were included...
August 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28719897/clinical-manifestations-and-prognostic-factors-of-pneumocystis-jirovecii-pneumonia-without-hiv
#19
Nobuhiro Asai, Shinji Motojima, Yoshihiro Ohkuni, Ryo Matsunuma, Takuya Iwasaki, Kei Nakashima, Keiji Sogawa, Tamao Nakashita, Norihiro Kaneko
INTRODUCTION: Pneumocystis jirovecii pneumonia (PCP) can occur in HIV patients but also in those without HIV (non-HIV PCP) but with other causes of immunodeficiency including malignancy or rheumatic diseases. OBJECTIVE AND METHODS: To evaluate the clinical presentation and prognostic factors of non-HIV PCP, we retrospectively reviewed all patients diagnosed as having PCP without HIV at Kameda Medical Center, Chiba, Japan, from January 2005 until June 2012. For the purpose of examining a prognostic factor for non-HIV PCP with 30-day mortality, we compared the characteristics of patients, clinical symptoms, radiological images, Eastern Cooperative Oncology Group performance status (PS), and the time from the onset of respiratory symptoms to the start of therapy, in both survival and fatality groups...
July 19, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28719295/regional-differences-in-the-prevalence-of-major-opportunistic-infections-among-antiretroviral-na%C3%A3-ve-human-immunodeficiency-virus-patients-in-japan-northern-thailand-northern-vietnam-and-the-philippines
#20
COMPARATIVE STUDY
Louie Mar A Gangcuangco, Ikumi Sawada, Naho Tsuchiya, Cuong D Do, Thanh Thuy T Pham, Archawin Rojanawiwat, Marissa Alejandria, Katerina Leyritana, Yoshiyuki Yokomaku, Panita Pathipvanich, Koya Ariyoshi
To identify regional differences in the distribution of opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in Asia, the medical records of antiretroviral therapy (ART)-naïve patients who attended the following tertiary hospitals from 2003 to 2011 were reviewed: Nagoya Medical Center (NMC, Nagoya, Japan), Lampang Hospital (LPH, Lampang, northern Thailand), Bach Mai Hospital (BMH, Hanoi, northern Vietnam), and Philippine General Hospital (PGH, Manila, Philippines). Logistic regression analyses were performed to identify associations between country of origin and risk of major OIs...
July 2017: American Journal of Tropical Medicine and Hygiene
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