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Abhijit Ray, Brian Khong, Hung T Khong
We describe a 69-year-old woman with metastatic breast cancer who developed dyspnea on exertion, persistent cough, fever and fatigue while on everolimus and exemestane combination. The initial differentials included opportunistic infection such as pneumocystis jiroveci pneumonia (PJP) vs. pneumonitis. Bronchoalveolar lavage (BAL) from bronchoscopy revealed PJP. The patient recovered after appropriate treatment. We also correlated the progressive decrease in her absolute lymphocyte count with PJP infection and recovery...
December 2016: Anticancer Research
Tsuneyo Mimori, Masayoshi Harigai, Tatsuya Atsumi, Takao Fujii, Masataka Kuwana, Hiroaki Matsuno, Shigeki Momohara, Syuji Takei, Naoto Tamura, Yoshinari Takasaki, Satoshi Ikeuchi, Satoru Kushimoto, Takao Koike
OBJECTIVE: To determine the real-world safety and effectiveness of iguratimod (IGU) for rheumatoid arthritis (RA), a 52-week, Japanese, postmarketing surveillance study was conducted. An interim analysis at week 24 was performed. METHODS: This study included all RA patients who received IGU following its introduction to the market. All adverse events (AEs) and adverse drug reactions (ADRs) were collected. Effectiveness was evaluated by the change in Disease Activity Score 28-C-reactive protein (DAS28-CRP) from baseline to week 24...
December 6, 2016: Modern Rheumatology
Marimuthu Ragavan Ramesh Kumar, Narasingam Arunagirinathan, Seetharaman Srivani, Aridoss Dhanasezhian, Nallusamy Vijaykanth, Natesan Manikandan, Sethuramalingam Balakrishnan, Ramachandran Vignesh, Pachamuthu Balakrishnan, Suniti Solomon, Sunil S Solomon
The antibiotic, trimethoprim-sulfamethoxazole (TMP-SMX), is generally used for prophylaxis in HIV individuals to protect them from Pneumocystis jiroveci infection. Long-term use of TMP-SMX develops drug resistance among bacteria in HIV patients. The study was aimed to detect the TMP-SMX resistance genes among gram-negative bacteria from HIV patients. TMP-SMX-resistant isolates were detected by the Kirby-Bauer disc diffusion method. While TMP resistance genes such as dfrA1, dfrA5, dfrA7, and dfrA17 and SMX resistance genes such as sul1 and sul2 were detected by multiplex PCR, class 1 and class 2 integrons were detected by standard monoplex PCR...
November 17, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
X Huang, L Weng, L Yi, M Li, Y Y Feng, Y Tian, J G Xia, Q Y Zhan, B Du
Objective: To examine the clinical features of patients with acute respiratory failure (ARF) caused by pneumocystis pneumonia (PCP) admitted into two medical intensive care units (ICU) in non- human immunodeficiency virus (HIV) infected immunocompromised patients. Methods: A retrospective review was conducted among 92 non-HIV patients with ARF caused by PCP in medical ICU of Peking Union Medical College Hospital and China-Japan Friendship Hospital between Jan 2010 and Dec 2015. Patient characteristics, clinical presentation, laboratory and radiological findings, complications, as well as therapy and mortality were included in the analysis...
October 18, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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
Shervin Shokouhi, Shabnam Tehrani, Marjan Hemmatian
UNLABELLED: Penicillium notatum is a fungus that widely exists in the environment and is often non-pathogenic to humans. However, in immunocompromised hosts it may be recognized as a cause of systemic mycosis. A 44-year-old man with acute myeloid leukemia (AML) was admitted to our hospital with fever and neutropenia. Due to no improvement after initial treatment, he underwent bronchoscopy. The patient was found to have P. notatum and Pneumocystis jiroveci infection, and therefore was given voriconazole, primaquine and clindamycin...
2016: Tanaffos
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
Courtney S Watts, Joseph N Sciasci, Jennifer L Pauley, John C Panetta, Deqing Pei, Cheng Cheng, Caroline M Christensen, Torben S Mikkelsen, Ching-Hon Pui, Sima Jeha, Mary V Relling
Trimethoprim-sulfamethoxazole (TMP/SMX) is used as prophylaxis against Pneumocystis jiroveci during chemotherapy. Many groups recommend withholding TMP/SMX during high-dose methotrexate (HDMTX) for concerns that it will delay methotrexate clearance. We compared methotrexate exposure following HDMTX (NCT00549848) in 424 patients including 783 courses that were given concurrently and 602 courses that were not given concurrently with TMP/SMX. Among 176 patients (555 courses) on the low-risk arm (HDMTX=2.5 g/m/24 h), there was no difference in clearance (110...
August 2016: Journal of Pediatric Hematology/oncology
Bruno Langevin, Mohamed Saleh
No abstract text is available yet for this article.
2016: BMJ Case Reports
D A Curi, R E Duerst, C Badke, J Bell, S Chaudhury, M Kletzel, J Schneiderman, W T Tse, W J Muller, N Hijiya
No abstract text is available yet for this article.
May 23, 2016: Bone Marrow Transplantation
Suhail Raoof, Praveen Bondalapati, Ravikanth Vydyula, Jay H Ryu, Nishant Gupta, Sabiha Raoof, Jeff Galvin, Mark J Rosen, David Lynch, William Travis, Sanjeev Mehta, Richard Lazzaro, David Naidich
Cysts are commonly seen on CT scans of the lungs, and diagnosis can be challenging. Clinical and radiographic features combined with a multidisciplinary approach may help differentiate among various disease entities, allowing correct diagnosis. It is important to distinguish cysts from cavities because they each have distinct etiologies and associated clinical disorders. Conditions such as emphysema, and cystic bronchiectasis may also mimic cystic disease. A simplified classification of cysts is proposed. Cysts can occur in greater profusion in the subpleural areas, when they typically represent paraseptal emphysema, bullae, or honeycombing...
October 2016: Chest
Jeonghoon Ha, Yunhwa Jung, Yunduk Jung, Sanbin Lee, Yoonseo Lee, Insook Woo
No abstract text is available yet for this article.
March 2016: Blood Research
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
Tania M Gonzalez Santiago, David A Wetter, Amer N Kalaaji, Andrew H Limper, Julia S Lehman
Pneumocystis jiroveci pneumonia is an opportunistic infection associated with substantial rates of mortality in immunosuppressed patients. Prophylaxis recommendations are mostly targeted toward patients with non-dermatologic diagnoses. This study was conducted to determine when dermatology patients treated with immunosuppressive medications should be offered P. jiroveci pneumonia prophylaxis. We searched the literature from January 1, 1993, to December 31, 2013, using terms relating to P. jiroveci pneumonia and dermatologic diagnoses to analyze the clinical characteristics of previously affected patients...
August 2016: International Journal of Dermatology
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
Umit Kervan, Seref Alp Kucuker, Sinan Sabit Kocabeyoglu, Ertekin Utku Unal, Mehmet Ali Ozatik, Dogan Emre Sert, Kemal Kavasoglu, Ayse Yasemin Tezer, Mustafa Pac
OBJECTIVES: Cytomegalovirus infection is a major cause of morbidity and mortality in solid-organ transplant. Low doses of valacyclovir have been administered as cytomegalovirus prophylaxis in our institution for years. To the best of our knowledge, there is no published study of a low-dose regimen for cytomegalovirus prophylaxis in heart transplant patients. Therefore, our aim was to determine the results of low doses of valacyclovir in heart transplant. MATERIALS AND METHODS: Between September 2006 and December 2014, sixty-eight patients underwent orthotopic heart transplants...
March 14, 2016: Experimental and Clinical Transplantation
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