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Immune reconstitutional syndrome

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https://www.readbyqxmd.com/read/27906037/integrated-therapy-for-hiv-and-cryptococcosis
#1
REVIEW
Sirawat Srichatrapimuk, Somnuek Sungkanuparph
Cryptococcosis has been one of the most common opportunistic infections and causes of mortality among HIV-infected patients, especially in resource-limited countries. Cryptococcal meningitis is the most common form of cryptococcosis. Laboratory diagnosis of cryptococcosis includes direct microscopic examination, isolation of Cryptococcus from a clinical specimen, and detection of cryptococcal antigen. Without appropriate treatment, cryptococcosis is fatal. Early diagnosis and treatment is the key to treatment success...
November 29, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906009/current-trends-and-intricacies-in-the-management-of-hiv-associated-pulmonary-tuberculosis
#2
REVIEW
Narendran Gopalan, Padmapriyadarsini Chandrasekaran, Soumya Swaminathan, Srikanth Tripathy
Human immunodeficiency virus (HIV) epidemic has undoubtedly increased the incidence of tuberculosis (TB) globally, posing a formidable global health challenge affecting 1.2 million cases. Pulmonary TB assumes utmost significance in the programmatic perspective as it is readily transmissible as well as easily diagnosable. HIV complicates every aspect of pulmonary tuberculosis from diagnosis to treatment, demanding a different approach to effectively tackle both the diseases. In order to control these converging epidemics, it is important to diagnose early, initiate appropriate therapy for both infections, prevent transmission and administer preventive therapy...
September 26, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906006/integrated-therapy-for-hiv-and-tuberculosis
#3
REVIEW
Weerawat Manosuthi, Surasak Wiboonchutikul, Somnuek Sungkanuparph
Tuberculosis (TB) has been the most common opportunistic infection and cause of mortality among HIV-infected patients, especially in resource-limited countries. Clinical manifestations of TB vary and depend on the degree of immunodeficiency. Sputum microscopy and culture with drug-susceptibility testing are recommended as a standard method for diagnosing active TB. TB-related mortality in HIV-infected patients is high especially during the first few months of treatment. Integrated therapy of both HIV and TB is feasible and efficient to control the diseases and yield better survival...
May 12, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27904430/natalizumab-related-progressive-multifocal-leukoencephalopathy-immune-reconstitution-inflammatory-syndrome-a-case-report-highlighting-clinical-and-mri-features
#4
Bela Purohit, Eranga Ganewatte, Spyros S Kollias
Multiple sclerosis (MS) patients treated with natalizumab often face the uncommon but severe complication of developing progressive multifocal leukoencephalopathy (PML). PML may be further complicated by immune reconstitution inflammatory syndrome (IRIS) after the removal of the drug. Since both PML and IRIS are associated with high morbidity and mortality rates, early clinical and radiological diagnosis of these complications is of paramount importance. Here, we report a case of an adult male patient who was diagnosed with PML after receiving natalizumab therapy for 6 years for the treatment of MS...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27862711/thalidomide-for-steroid-dependent-chronic-disseminated-candidiasis-after-stem-cell-transplantation-a-case-report
#5
Blandine Rammaert, Sophie Candon, Christophe Maunoury, Marie-Elisabeth Bougnou, Grégory Jouvion, Thorsten Braun, Jean-Michel Correas, Olivier Lortholary
Chronic disseminated candidiasis (CDC) is a rare and difficult-to-treat invasive fungal disease occurring mainly after prolonged and profound neutropenia. We describe the case of a 59-year-old man successfully treated with thalidomide for CDC recurrences after an autologous transplantation. We add evidences of the effectiveness of immunomodulatory drugs to manage inflammatory reconstitution immune syndrome-related refractory CDC. This article is protected by copyright. All rights reserved.
November 16, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27853087/mycobacterium-shigaense-causes-lymph-node-and-cutaneous-lesions-as-immune-reconstitution-syndrome-in-an-aids-patient-the-third-case-report-of-a-novel-strain-non-tuberculous-mycobacterium
#6
Yusuke Koizumi, Kaoru Shimizu, Masayo Shigeta, Hitoshi Minamiguchi, Keiko Hodohara, Akira Andoh, Toshihide Tanaka, Kinuyo Chikamatsu, Satoshi Mitarai, Hiroshige Mikamo
A 40-year-old man complaining of progressive body weight loss was diagnosed to have acquired immunodeficiency syndrome. Within 2 weeks after the initiation of combination antiretroviral therapy, he developed fever, massive cervical lymphadenopathy and a protruding subcutaneous abscess. A lymph node biopsy and abscess drainage revealed non-caseous granuloma and mycobacterium. The mycobacterium belonged to Runyon II group, but it showed no matches to any previously reported species. According to sequence analyses, the strain was identified as Mycobacterium shigaense...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27851430/1795-life-threatening-immune-reconstitution-inflammatory-syndrome-due-to-m-kansasii-in-an-aids-patient
#7
Naseem Alavian, Simon Yau, Nicola Hanania
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843370/rheumatoid-arthritis-in-patients-with-hiv-management-challenges
#8
REVIEW
Matthew B Carroll, Joshua H Fields, Philip G Clerc
Over the past few decades, HIV has been transformed from a once-uniformly fatal disease to now a manageable but complex multisystem illness. Before highly active antiretroviral therapy (HAART), reports suggested that HIV-infected patients with rheumatoid arthritis (RA) would experience remission of their disease. It has now become clear that RA can develop in HIV-infected patients at any time, independent of HAART. Choosing the right medication to treat symptoms related to RA while avoiding excess weakening of the immune system remains a clinical challenge...
2016: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/27828731/the-pharmacological-challenges-of-treating-tuberculosis-and-hiv-coinfections
#9
Eric F Egelund, Lori Dupree, Emily Huesgen, Charles A Peloquin
Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis...
November 28, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27818191/corticosteroids-for-the-management-of-severe-intracranial-hypertension-in-meningoencephalitis-caused-by-cryptococcus-gattii-a-case-report-and-review
#10
R-A Maciel, L-S Ferreira, F Wirth, P-D Rosa, M Aves, E Turra, L-Z Goldani
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C...
November 3, 2016: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/27801977/immune-reconstitution-inflammatory-syndrome-in-hiv-infection-taking-the-bad-with-the-good
#11
Chun-Shu Wong, Elizabeth S Richards, Luxin Pei, Irini Sereti
In this review we will describe the immunopathogies of immune reconstitution inflammatory syndrome, IRIS. IRIS occurs in a small subset of HIV patient, initiating combination antiretroviral therapy (ART), where immune reconstitution becomes dyregulated, resulting in an overly robust antigen-specific inflammatory reaction. We will discuss IRIS in terms of the associated coinfections: mycobacteria, cryptococci, and viruses. This article is protected by copyright. All rights reserved.
November 1, 2016: Oral Diseases
https://www.readbyqxmd.com/read/27800196/chronic-disseminated-candidiasis-complicated-by-immune-reconstitution-inflammatory-syndrome-in-child-with-acute-lymphoblastic-leukemia
#12
Olga Zając-Spychała, Bogna Ukielska, Katarzyna Jończyk-Potoczna, Benigna Konatkowska, Jacek Wachowiak
Hepatosplenic candidiasis also known as chronic disseminated candidiasis is a rare manifestation of invasive fungal infection typically observed in patients with acute leukemia in prolonged, deep neutropenia. Immune reconstitution inflammatory syndrome (IRIS) is an inflammatory disorder triggered by rapid resolution of neutropenia. Diagnosis and treatment of IRIS are still challenging due to a variety of clinical symptoms, lack of certain diagnostic criteria, and no standards of treatment. The diagnosis of IRIS is even more difficult in patients with hematological malignancies complicated by "probable" invasive fungal infection, when fungal pathogen is still uncertain...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27786246/hiv-associated-opportunistic-cns-infections-pathophysiology-diagnosis-and-treatment
#13
REVIEW
Lauren N Bowen, Bryan Smith, Daniel Reich, Martha Quezado, Avindra Nath
Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis...
October 27, 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27762593/the-expression-level-of-neutrophil-cd64-is-a-useful-marker-of-systemic-inflammation-associated-with-hiv-infection
#14
Fujiko Mitsumoto-Kaseida, Masayuki Murata, Kazuya Ura, Koji Takayama, Satoshi Hiramine, Motohiro Shimizu, Kazuhiro Toyoda, Eiichi Ogawa, Norihiro Furusyo
CD64 is an Fc-gamma-receptor type 1. The expression level of neutrophil CD64 (nCD64) is a known bacterial infection marker, and it also increases in viral infections. We examined the absolute nCD64 before and after the initiation of antiretroviral therapy (ART) to determine its role as an infection and inflammation marker of human immunodeficiency virus (HIV) infection. In this prospective observational study, ninety-four HIV infected patients were enrolled and classified into ART (n=62), ART naive (n=24), and acute/early phase groups (n=8)...
October 20, 2016: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/27756254/severe-inflammatory-disease-activity-14%C3%A2-months-after-cessation-of-natalizumab-in-a-patient-with-leber-s-optic-neuropathy-and-multiple-sclerosis-a-case-report
#15
Trygve Holmøy, Antonie G Beiske, Svetozar Zarnovicky, Aija Zuleron Myro, Egil Røsjø, Emilia Kerty
BACKGROUND: Leber's hereditary optic neuropathy (LHON) co-occuring with multiple sclerosis-like disease (LHON-MS) is suggested to be a separate disease entity denoted Harding's disease. Little is known about the response to initiation and discontinuation of potent immunomodulatory treatment in LHON-MS. CASE PRESENTATION: We describe a LHON-MS patient with 27 years disease duration who developed severe disease activity peaking 14 months after discontinuation of natalizumab, with extensive new inflammatory lesions throughout the brain and in the spinal cord resembling immune inflammatory reconstitution syndrome...
October 18, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27753773/thalidomide-in-refractory-tuberculomas-and-pseudoabscesses
#16
Isabelle Viel-Thériault, Roseline Thibeault, Francois D Boucher, Jean-Philippe Drolet
Paradoxical immune reconstitution inflammatory syndrome is a well-described entity even in immunocompetent children, principally in association with Mycobacterium tuberculosis infections. Central nervous system involvement is a potential life-threatening form, sometimes refractory to standard treatment. We report the case of an HIV-negative refugee teenager, who presented with brain tuberculomas and pseudoabscesses responsive only to thalidomide.
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27751177/successful-treatment-with-fecal-microbiota-transplantation-in-patients-with-multiple-organ-dysfunction-syndrome-and-diarrhea-following-severe-sepsis
#17
Yanling Wei, Jun Yang, Jun Wang, Yang Yang, Juan Huang, Hao Gong, Hongli Cui, Dongfeng Chen
BACKGROUND: The dysbiosis of intestinal microbiota plays an important role in the development of gut-derived infections, making it a potential therapeutic target against multiple organ dysfunction syndrome (MODS) after sepsis. However, the effectiveness of fecal microbiota transplantation (FMT) in treating this disease has been rarely investigated. METHODS: Two male patients, a 65-year-old and an 84-year-old, were initially diagnosed with cerebellar hemorrhage and cerebral infarction, respectively, after admission...
October 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27742137/-uncommon-cutaneous-presentation-of-visceral-leishmaniasis-associated-with-hiv
#18
C Cossart, G Le Moal, M Garcia, E Frouin, E Hainaut-Wierzbicka, F Roblot
BACKGROUND: Visceral leishmaniasis is not normally expressed in skin. Herein, we describe the case of an HIV-positive patient who developed two unusual skin manifestations during an episode of visceral leishmaniasis. PATIENTS AND METHODS: A 48-year-old female patient consulted initially for infiltrated purpura of all four limbs. Skin biopsy revealed leukocytoclastic vasculitis with Leishman-Donovan bodies. Laboratory tests showed medullary, splenic, gastric and colic involvement, suggesting systemic disease, and enabling visceral leishmaniasis to be diagnosed...
December 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/27733639/strongyloidiasis-related-iris-a-case-report-and-literature-review
#19
Haggai Bar-Yoseph, Yaniv Zohar, Margalit Lorber
Helminthic infection and HIV have been reported to coexist, particularly in sub-Saharan African patients living with HIV. Strongyloidiasis is one of the most common helminths, usually leading to cutaneous and gastrointestinal (GI) symptoms. In the immunocompromised host, this infection can lead to strongyloidiasis hyperinfection syndrome (SHS), not common in HIV-infected patients. Immune reconstitution inflammatory syndrome (IRIS) can follow the initiation of antiretroviral therapy (ART), with a variety of presentations...
October 12, 2016: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/27726783/surgical-pathologic-diagnosis
#20
Mary K Klassen-Fischer, Ronald C Neafie
Surgical pathology results can play a crucial role in the management of immunocompromised patients. Here we highlight factors that differ between immunocompromised and immunocompetent hosts, such as variation in inflammatory response. Conditions that are covered include drug reactions, disease within solid organ allografts, immune reconstitution inflammatory syndrome, specific immunodeficiency syndromes, neoplasms related to viral infections, and viral, bacterial, fungal, and parasitic infections. Special techniques including immunohistochemistry, in situ hybridization and molecular detection of pathogen nucleic acid from formalin-fixed, paraffin-embedded tissue are discussed...
August 2016: Microbiology Spectrum
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