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Opportunistic illness

Paola Nóbrega Souza, Erique José Peixoto de Miranda, Ronaldo Cruz, Daniel Neves Forte
OBJECTIVE: To describe the characteristics of patients with HIV/AIDS and to compare the therapeutic interventions and end-of-life care before and after evaluation by the palliative care team. METHODS: This retrospective cohort study included all patients with HIV/AIDS admitted to the intensive care unit of the Instituto de Infectologia Emílio Ribas who were evaluated by a palliative care team between January 2006 and December 2012. RESULTS: Of the 109 patients evaluated, 89% acquired opportunistic infections, 70% had CD4 counts lower than 100 cells/mm3, and only 19% adhered to treatment...
September 2016: Revista Brasileira de Terapia Intensiva
L Stratton, G R Caddy
Patients with Crohn's disease often require the use of immunosuppressant drugs to control disease activity. Such medication includes steroids, azathioprine, and biologic therapy. These suppress the immune response, and the patient is more susceptible to infection. We present a case of a 69-year-old gentleman with a history of Crohn's colitis who had ongoing symptoms of diarrhoea in spite of standard treatment. Biologic therapy was considered to be the next step, and screening for infection was undertaken prior to use...
2016: Case Reports in Gastrointestinal Medicine
Leah T Le, Serena S Spudich
Since the advent of combination antiretroviral therapy (cART), HIV has transformed from a fatal disease to a chronic illness that often presents with milder central nervous system (CNS) symptoms laced with related confounders. The immune recovery associated with access to cART has led to a new spectrum of immune-mediated presentations of infection, phenotypically distinct from the conditions observed in advanced disease.HIV-associated neurocognitive disorder (HAND) entails a categorized continuum of disorders reflecting an array of clinical presentation, outcome, and increasing level of severity: asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD)...
August 2016: Seminars in Neurology
Elena N Naumova, Alexander Liss, Jyotsna S Jagai, Irmgard Behlau, Jeffrey K Griffiths
The Flint Water Crisis-due to changes of water source and treatment procedures-has revealed many unsolved social, environmental, and public health problems for US drinking water, including opportunistic premise plumbing pathogens (OPPP). The true health impact of OPPP, especially in vulnerable populations such as the elderly, is largely unknown. We explored 10(8) claims in the largest US national uniformly collected data repository to determine rates and costs of OPPP-related hospitalizations. In 1991-2006, 617,291 cases of three selected OPPP infections resulted in the elderly alone of $0...
September 12, 2016: Journal of Public Health Policy
Yi-Wen Qian, Chuan Li, Ai-Ping Jiang, Shengfang Ge, Ping Gu, Xianqun Fan, Tai-Sheng Li, Xia Jin, Jian-Hua Wang, Zhi-Liang Wang
Approximately 70% of HIV-1 infected patients acquire ocular opportunistic infections and manifest eye disorders during the course of their illness. The mechanisms by which pathogens invade the ocular site, however, are unclear. Under normal circumstance, vascular endothelium and retinal pigment epithelium (RPE) that possess a well-developed tight junction complex form the blood-retinal barrier (BRB) to prevent pathogen invasion. We hypothesize that the disruption of BRB allows pathogen entry into the ocular sites...
September 7, 2016: Journal of Biological Chemistry
Simona Frunza-Stefan, Gyanendra Acharya, Viktoryia Kazlouskaya, Paunel Vukasinov, Yushan Chiou, Zeyar Thet
Immune reconstitution inflammatory syndrome (IRIS) is a condition associated with paradoxical worsening and/or new onset of an opportunistic infection in HIV patients following the initiation of anti-retroviral therapy or switching to more potent antiretroviral therapy (ART) regimen. Although IRIS associated with many opportunistic infections (OIs) has been well reported, syphilis has very rarely been mentioned in this regard. A 52-year-old male, diagnosed with AIDS six weeks ago, presented with the disseminated non-pruritic painless skin rash...
August 26, 2016: International Journal of STD & AIDS
Alka Khaitan, Max Kilberg, Adam Kravietz, Tiina Ilmet, Cihan Tastan, Mussa Mwamzuka, Fatma Marshed, Mengling Liu, Aabid Ahmed, William Borkowsky, Derya Unutmaz
Mucosal-associated invariant T cells (MAIT) are innate T cells restricted by major histocompatibility related molecule 1 (MR1) presenting riboflavin metabolite ligands derived from microbes. Specificity to riboflavin metabolites confers MAIT cells a broad array of host-protective activity against gram-negative and -positive bacteria, mycobacteria, and fungal pathogens. MAIT cells are present at low levels in the peripheral blood of neonates and gradually expand to relatively abundant levels during childhood...
2016: PloS One
Lori E A Bradford, Udoka Okpalauwaekwe, Cheryl L Waldner, Lalita A Bharadwaj
BACKGROUND: Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. OBJECTIVE: The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. DESIGN: A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada...
2016: International Journal of Circumpolar Health
Soo Shen Ooi, Joon Wah Mak, Donald K F Chen, Stephen Ambu
BACKGROUND: The free-living protozoan Acanthamoeba is an opportunistic pathogen that is ubiquitous in our environment. However, its role in affecting indoor air quality and ill-health of indoor occupants is relatively unknown. The present study investigated the presence of Acanthamoeba from the ventilation system and its correlation with other indoor air quality parameters, used in the industry code of practice and its potential as an indicator for indoor air quality. METHODS: Indoor air quality assessments were carried out in nine commercial buildings with approval from the building management, and the parameters assessed were as recommended by the Department of Occupational Safety and Health...
July 29, 2016: Industrial Health
Torsak Bunupuradah, Sasisopin Kiertiburanakul, Anchalee Avihingsanon, Ploenchan Chetchotisakd, Malee Techapornroong, Niramon Leerattanapetch, Pacharee Kantipong, Chureeratana Bowonwatanuwong, Sukit Banchongkit, Virat Klinbuayaem, Sripetcharat Mekviwattanawong, Sireethorn Nimitvilai, Supunnee Jirajariyavej, Wisit Prasithsirikul, Warangkana Munsakul, Sorakij Bhakeecheep, Suchada Chaivooth, Praphan Phanuphak, David A Cooper, Tanakorn Apornpong, Stephen J Kerr, Sean Emery, Kiat Ruxrungtham
BACKGROUND: Thai patients with HIV have higher exposure to HIV protease inhibitors than do white people and dose reduction might be possible. We compared the efficacy of low-dose with standard-dose ritonavir-boosted atazanavir in virologically suppressed Thai patients with HIV. METHODS: In this randomised, open-label, non-inferiority trial, we recruited patients aged 18 years or older who were receiving ritonavir-boosted protease-inhibitor-based antiretroviral therapy (ART) with HIV plasma viral loads of less than 50 copies per mL, an alanine aminotransferase concentration of less than 200 IU/L, and a creatinine clearance of at least 60 mL/min from 14 hospitals in Thailand...
August 2016: Lancet HIV
Ha Thuc Ai Hien, Tran Tan Thanh, Nguyen Thi Mai Thu, Ashley Nguyen, Nguyen Tat Thanh, Nguyen Phu Huong Lan, Cameron Simmons, Cecilia Shikuma, Nguyen Van Vinh Chau, Guy Thwaites, Thuy Le
Penicilliosis caused by Talaromyces marneffei is a common AIDS-defining illness in South and Southeast Asia. Diagnosis is based on culture which can take up to 14 days for identification, leading to treatment delay and increased mortality. We developed a TaqMan real-time PCR assay targeting the MP1 gene encoding an abundant cell wall protein specific to T. marneffei. The assay's performance was evaluated in MP1-containing plasmids, clinical isolates, and plasma from HIV-infected patients with and without penicilliosis...
July 25, 2016: Mycoses
H Dele Davies
Biologic response modifiers (BRMs) are substances that interact with and modify the host immune system. BRMs that dampen the immune system are used to treat conditions such as juvenile idiopathic arthritis, psoriatic arthritis, or inflammatory bowel disease and often in combination with other immunosuppressive agents, such as methotrexate and corticosteroids. Cytokines that are targeted include tumor necrosis factor α; interleukins (ILs) 6, 12, and 23; and the receptors for IL-1α (IL-1A) and IL-1β (IL-1B) as well as other molecules...
August 2016: Pediatrics
Martin Mbonye, Janet Seeley, Ruth Nalugya, Thadeus Kiwanuka, Daniel Bagiire, Michelle Mugyenyi, Gertrude Namale, Yunia Mayanja, Anatoli Kamali
At the end of 2013, the Government of Uganda issued guidance recommending provision of Anti-Retroviral Treatment (ART) to HIV-positive people in key populations, including female sex workers, regardless of CD4 cell count. We describe the implementation of this new guidance in a clinic serving women at high risk of HIV infection in Kampala. Between July and December 2015, we conducted repeat in-depth interviews with 15 women attending the clinic after the change in guidelines, to explore their perceptions regarding prompt ART initiation...
2016: AIDS Care
Helen F Titmarsh, Stephanie M Lalor, Severine Tasker, Emily N Barker, Jacqueline Berry, Danielle Gunn-More, Richard J Mellanby
Feline immunodeficiency virus (FIV) is a lentivirus that can lead to a syndrome of acquired immune dysfunction. Infected cats often remain asymptomatic for several years before immune dysfunction leads to an increased risk for the development of systemic diseases, neoplasia and opportunistic infections. FIV is structurally related to human immunodeficiency virus (HIV) and the pathogenesis of FIV-related disease is similar to that seen in HIV-infected patients. Observational studies have documented an association between low plasma vitamin D and HIV infection...
October 2015: Veterinary Medicine and Science
Rachel E Goldberg, Susan E Short
Millions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being...
March 2016: AIDS Care
Kathryn A Trebuss, Samantha Buttemer, Jeffrey S Wilkinson, Josie Xu, John P Rossiter, Kieran M Moore
Tumour necrosis factor alpha inhibitors, such as infliximab, and other biologic agents are associated with increased risk of opportunistic infection, including tuberculosis. Tuberculosis infections associated with infliximab tend to present atypically and can be difficult to diagnose, as they are more likely to manifest as extrapulmonary or disseminated disease. The authors report a case involving a 29-year-old male patient who died following 16 days of treatment for undifferentiated sepsis and who was found on autopsy to have widespread disseminated tuberculosis...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Varun K Phadke, Jesse T Jacob
A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation...
May 2016: Infectious Diseases in Clinical Practice: IDCP
Adedoyin Awofisayo-Okuyelu, Neville Q Verlander, Corinne Amar, Richard Elson, Kathie Grant, John Harris
BACKGROUND: Listeriosis is an opportunistic bacterial infection caused by Listeria monocytogenes and predominantly affects people who are immunocompromised. Due to its severity and the population at risk, prompt clinical diagnosis and treatment of listeriosis is essential. A major step to making a clinical diagnosis is the collection of the appropriate specimen(s) for testing. This study explores factors that may influence the time between onset of illness and collection of specimen in order to inform clinical policy and develop necessary interventions...
2016: BMC Infectious Diseases
Payam Fathi, Shaoguang Wu
Bacteroides fragilis is an extensively studied anaerobic bacterium comprising the normal flora of the human gut. B. fragilis is known to be one of the most commonly isolated species from clinical samples and has been shown to cause a wide range of pathologies in humans [1, 2]. As an opportunistic pathogen B. fragilis can cause abscess formation and bacteremia [2]. Additionally in its enterotoxigenic form, B. fragilis is a known cause of diarrheal illness, is associated with inflammatory bowel disease, and has been recently characterized in patients with colon cancer [3 - 5]...
2016: Open Microbiology Journal
Caitlin S Brown, Kianoush B Kashani, Jeremy M Clain, Erin N Frazee
Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR) surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS) because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis...
2016: Case Reports in Nephrology
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