RESUMEN
Pulmonary cryptosporidiosis is a rare complication of intestinal cryptosporidiosis in AIDS patients. We report the epidemiological, clinical, radiological, microbiological and immunological findings in 5 AIDS patients with pulmonary cryptosporidiosis. Diagnosis was based on the detection of acid-fast oocysts in sputum or aspirated bronchial material using the Kinyoun technique. Microbiology laboratories should be alert to the possibility of Cryptosporidium spp oocysts presence in respiratory specimens from patients with advanced HIV/AIDS disease and pulmonary involvement.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Criptosporidiosis/etiología , Enfermedades Pulmonares Parasitarias/etiología , Adulto , Humanos , MasculinoRESUMEN
La criptosporidiosis pulmonar es una rara complicación de la enfermedad intestinal causada por este agente en pacientes con SIDA. En este trabajo se describen las características epidemiológicas, clínicas, radiológicas, microbiológicas e inmunológicas de 5 pacientes con SIDA y criptosporidiosis pulmonar. El diagnóstico de la localización pulmonar se basó en el hallazgo de ooquistes de Cryptosporidium spp. en muestras de esputo o lavado broncoalveolar utilizando la coloración de Kinyoun. Los laboratorios de microbiología deben estar alerta ante la posibilidad de identificar ooquistes de Cryptosporidium spp. en secreciones broncopulmonares de pacientes con enfermedad VIH/SIDA avanzada.
Pulmonary cryptosporidiosis is a rare complication of intestinal cryptosporidiosis in AIDS patients. We report the epidemiological, clinical, radiological, microbiological and immunological findings in 5 AIDS patients with pulmonary cryptosporidiosis. Diagnosis was based on the detection of acid-fast oocysts in sputum or aspirated bronchial material using the Kinyoun technique. Microbiology laboratories should be alert to the possibility of Cryptosporidium spp oocysts presence in respiratory specimens from patients with advanced HIV/AIDS disease and pulmonary involvement.
Asunto(s)
Adulto , Humanos , Masculino , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Criptosporidiosis/etiología , Enfermedades Pulmonares Parasitarias/etiologíaRESUMEN
We conducted a retrospective evaluation to determine the clinical and microbiological characteristics of 61 episodes of infective endocarditis (IE) in intravenous drug abusers (IDA), HIV seropositive patients. Forty-nine males and 6 females between 15 and 42 years of age were included in the study. All the included patients presented 61 episodes of IE. Fever and cardiac murmur were present in all episodes; 43 (70.4%) had hepatomegaly; 29 (47.5%) had splenomegaly. Thirty-eight (62.3%) presented cough (9 with hemoptysis); 25 (41%) had dyspnea, and 5 (8.2%) had jugular ingurgitation. Fundoscopy showed alterations in 3 patients (4.9%). Bacteriological confirmation was obtained in 41 episodes (67.2%); blood cultures revealed Staphylococcus aureus in 30 cases (73.1%), Streptococcus viridans in 8 (19.5%) patients, Staphylococcus epidermidis in 1 (2.4%), Staphylococcus hominis in 1 (2.4%) and Streptococcus pneumoniae in one case (2.4%). The tricuspid valve was involved in 51 episodes (83.6%), the aorta in 6 (9.8%), the mitral valve in 3 (4.9%) and the pulmonary valve in one (1.6%). There was evidence of right bivalvular involvement in 2 patients (3.2%) and tricuspid and mitral involvement in another (1.6%). Pericardial effusion was detected in 19 episodes (31.1%). Six patients (10.9%) died during the acute episode of IE.
Asunto(s)
Endocarditis Bacteriana/complicaciones , Infecciones por VIH/complicaciones , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adolescente , Adulto , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/microbiología , Femenino , VIH-1 , Humanos , Masculino , Estudios RetrospectivosRESUMEN
We conducted a retrospective evaluation to determine the clinical and microbiological characteristics of 61 episodes of infective endocarditis (IE) in intravenous drug abusers (IDA), HIV seropositive patients. Forty-nine males and 6 females between 15 and 42 years of age were included in the study. All the included patients presented 61 episodes of IE. Fever and cardiac murmur were present in all episodes; 43 (70.4
) presented cough (9 with hemoptysis); 25 (41
) had dyspnea, and 5 (8.2
) had jugular ingurgitation. Fundoscopy showed alterations in 3 patients (4.9
). Bacteriological confirmation was obtained in 41 episodes (67.2
); blood cultures revealed Staphylococcus aureus in 30 cases (73.1
), Streptococcus viridans in 8 (19.5
) patients, Staphylococcus epidermidis in 1 (2.4
), Staphylococcus hominis in 1 (2.4
) and Streptococcus pneumoniae in one case (2.4
). The tricuspid valve was involved in 51 episodes (83.6
), the aorta in 6 (9.8
), the mitral valve in 3 (4.9
) and the pulmonary valve in one (1.6
). There was evidence of right bivalvular involvement in 2 patients (3.2
) and tricuspid and mitral involvement in another (1.6
). Pericardial effusion was detected in 19 episodes (31.1
) died during the acute episode of IE.
RESUMEN
We conducted a retrospective evaluation to determine the clinical and microbiological characteristics of 61 episodes of infective endocarditis (IE) in intravenous drug abusers (IDA), HIV seropositive patients. Forty-nine males and 6 females between 15 and 42 years of age were included in the study. All the included patients presented 61 episodes of IE. Fever and cardiac murmur were present in all episodes; 43 (70.4
) had hepatomegaly; 29 (47.5
) had splenomegaly. Thirty-eight (62.3
) presented cough (9 with hemoptysis); 25 (41
) had dyspnea, and 5 (8.2
) had jugular ingurgitation. Fundoscopy showed alterations in 3 patients (4.9
). Bacteriological confirmation was obtained in 41 episodes (67.2
); blood cultures revealed Staphylococcus aureus in 30 cases (73.1
), Streptococcus viridans in 8 (19.5
) patients, Staphylococcus epidermidis in 1 (2.4
), Staphylococcus hominis in 1 (2.4
) and Streptococcus pneumoniae in one case (2.4
). The tricuspid valve was involved in 51 episodes (83.6
), the aorta in 6 (9.8
), the mitral valve in 3 (4.9
) and the pulmonary valve in one (1.6
). There was evidence of right bivalvular involvement in 2 patients (3.2
) and tricuspid and mitral involvement in another (1.6
). Pericardial effusion was detected in 19 episodes (31.1
). Six patients (10.9
) died during the acute episode of IE.
RESUMEN
Fueron tratados con itraconazol 13 pacientes con paracoccidioidomicosis y 13 con histoplasmosis, todos adultos de sexo masculino. Aquellos con paracoccidioidomicosis exhibieron la forma crónica tipo adulto de la enfermedad con compromiso de por lo menos dos órganos. El itraconazol fue administrado en dosis de 50mg por día tomados después del desayuno durante 6 meses. Todos las infecciones curaron a excepción de una que presentó mejoría de los parámetros clínicos, bioquímicos e inmunológicos. Doce pacientes con histoplasmosis tenían la forma diseminadada crónica, el restante presentó la forma pulmonar cavitaria crónica. La dosis de itraconazol fue de 100mg diarios en una sola toma durante 6 meses. Once infecciones fueron curadas y una presentó mejoría significativa. El paciente restante falleció debido a una intercurrencia no relacionada con la micosis. Hasta el momento de su muerte pudo demostrarse mejoría de todos los parámetros de seguimiento
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Histoplasmosis/tratamiento farmacológico , Paracoccidioidomicosis/tratamiento farmacológico , Triazoles/uso terapéutico , Cetoconazol/uso terapéutico , Triazoles/efectos adversosRESUMEN
Fueron tratados con itraconazol 13 pacientes con paracoccidioidomicosis y 13 con histoplasmosis, todos adultos de sexo masculino. Aquellos con paracoccidioidomicosis exhibieron la forma crónica tipo adulto de la enfermedad con compromiso de por lo menos dos órganos. El itraconazol fue administrado en dosis de 50mg por día tomados después del desayuno durante 6 meses. Todos las infecciones curaron a excepción de una que presentó mejoría de los parámetros clínicos, bioquímicos e inmunológicos. Doce pacientes con histoplasmosis tenían la forma diseminadada crónica, el restante presentó la forma pulmonar cavitaria crónica. La dosis de itraconazol fue de 100mg diarios en una sola toma durante 6 meses. Once infecciones fueron curadas y una presentó mejoría significativa. El paciente restante falleció debido a una intercurrencia no relacionada con la micosis. Hasta el momento de su muerte pudo demostrarse mejoría de todos los parámetros de seguimiento (AU)