cefotaxime and HIV-Infections

A case of spleen abscess complicating Salmonella bacteremia in a HIV-infected patient is reported for the first time. Chronic pancreatitis and the infection of a pre-existing pseudocyst of the pancreas tail might have been the predisposing factor. Infection developed before other AIDS criteria were evident in the patient. Splenectomy plus antibiotic therapy was required to eradicate the process. Salmonella enteritidis was cultured from two suppurated lesions of the excised organ.

Topics: Abscess; Adult; Cefotaxime; HIV Infections; HIV-1; Humans; Male; Salmonella enteritidis; Salmonella Infections; Splenectomy; Splenic Diseases; Ultrasonography

An open, randomized, multicentre clinical trial was conducted to compare the efficacy and safety of cefepime 2 g iv bd (2 g tds daily in cases of Pseudomonas aeruginosa pneumonia) with cefotaxime 2 g iv tds, in the empirical treatment of bacterial pneumonia in HIV-infected patients. The primary end-point was effectiveness after 3-5 days of treatment, taking success to be when the study drug was continued during this period of time. Clinical and bacteriological responses at end of treatment (EOT) were also evaluated. Analyses of the intention-to-treat population (n = 160) and the as-per-protocol groups (n = 150) were carried out. Treatment groups were comparable with regard to sex, age, HIV status and degree of severity of pneumonia. The primary end-point for cefepime was considered successful for the intention-to-treat and as-per-protocol groups in 85.7% and 93.5% of cases, respectively, and for cefotaxime, in 77.6% and 80.8% of cases, respectively (P = 0.22 and P = 0.02). In the as-per-protocol group, cefotaxime treatment was independently related to failure at the primary end-point. A satisfactory clinical response in the intention-to-treat population was observed in 83.3% of cefepime and 82.9% of cefotaxime patients. Bacteriological cure was obtained in 100% of evaluable cefepime and 93.4% of evaluable cefotaxime patients at EOT. Safety of the study drugs was comparable in both treatment groups. Cefepime 2 g iv bd was at least as effective and as well tolerated as cefotaxime 2 g iv tds in the treatment of bacterial pneumonia in HIV-infected patients.

Topics: Adult; Cefepime; Cefotaxime; Cephalosporins; Empiricism; Female; HIV Infections; Humans; Male; Pneumonia, Bacterial; Treatment Outcome

In this visual case of Strongyloides stercoralis disseminated infection with Enterobacteriaceae-related invasive infection, we demonstrated the in-host S. stercoralis circulation with DNA found in different fluids and specimens, but also in cerebrospinal fluid (CSF), supporting the role of migrant larvae in the Enterobacteriaceae-related invasive and central nervous system infection.

Topics: Aged; Animals; Anti-Bacterial Agents; Anti-HIV Agents; Antiparasitic Agents; Cefotaxime; DNA, Protozoan; Escherichia coli; Escherichia coli Infections; Feces; Ganciclovir; HIV Infections; Humans; Ivermectin; Male; Strongyloides stercoralis; Strongyloidiasis

Invasive pneumococcal disease (IPD) has an all-cause mortality of 5-35 % in the developed world. Pneumococcal vaccination is recommended for at-risk groups, including those infected with human immunodeficiency virus (HIV) and those over 65 years of age. However, adherence to vaccination guidelines is low. We reviewed all cases of IPD in our tertiary referral hospital from 2006 to 2010. IPD was defined as the isolation of Streptococcus pneumoniae from a normally sterile site with a compatible clinical syndrome. Demographics, risk factors, susceptibilities, pneumococcal serotype, mortality, and vaccination status for each patient were analyzed. There were 127 IPD episodes in 122 patients. The overall case fatality rate was 21.2 %. Seventy-two percent of the patients had two or more risk factors that should have prompted pneumococcal vaccination. However, the overall pneumococcal vaccination provision was only 9 %: 64.6 % of all typed isolates were contained in the pneumococcal polysaccharides vaccine 23 (PPV23), 48.8 % in the 7-valent pneumococcal conjugate vaccine (PCV7), and 60.1 % in PCV13. All isolates were fully sensitive to penicillin and cefotaxime. Recurrent IPD was seen in 11 % of the HIV-infected patients, highlighting a particular at-risk group. IPD has a high mortality rate. There is low vaccine provision in our study, although most IPD patients had risk factors that should have prompted vaccination. HIV-positive people are particularly at risk; vaccinating those with persisting CD4 counts less than 200 cells/mm(3) and the use of "prime-boost" strategies may decrease incidence in the future. Newer models of care such as a dedicated vaccine clinic as described in this study may help increase vaccine provision and uptake.

Topics: Anti-Bacterial Agents; Cefotaxime; Female; HIV Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Pneumococcal Infections; Pneumococcal Vaccines; Risk Factors; Streptococcus pneumoniae; Tertiary Care Centers; Vaccination

Topics: Acquired Immunodeficiency Syndrome; Anti-Bacterial Agents; Antiretroviral Therapy, Highly Active; Cambodia; Cefotaxime; Child; Drug Resistance, Bacterial; Enterobacter; Enterobacteriaceae Infections; HIV Infections; Humans; Klebsiella; Klebsiella Infections; Opportunistic Infections

Fever is a protective and adaptive reaction, an early and obligatory symptom of infectious diseases in the first place. Historically, this term has been used in the names of more than 20 infectious diseases. Fever may also be a manifestation of other diseases accompanied by aseptic inflammation and neurohumoral disturbances. The growth rate of fever and the character of its circadian fluctuations at the beginning of the disease, as well as its total duration, the height and type of temperature curve, and time of onset of organic lesions should be taken into consideration when performing differential diagnostics of fevers of different origins. The authors developed an algorithm of differential diagnostics of febrile conditions. When an infectious process is excluded reasonably, the patient should undergo further examination for early detection of other diseases accompanied by fever.

Topics: Anti-Bacterial Agents; Cefotaxime; Diagnosis, Differential; Fever; HIV Antibodies; HIV Infections; HIV-1; Humans; Immunoblotting; Male; Middle Aged

Simultaneous co-infections of Borrelia burgdorferi sensu lato and HIV-1 are rare events, with only six published cases. A case of acute neuroborreliosis with facial palsy, meningoradiculitis (Bannwarth's syndrome) in an HIV-1 positive individual is described. Diagnosis was confirmed by Western immunoblot analysis of serum and CSF and by proof of intrathecal production of antibodies against B. garinii. The patient was successfully treated with cefotaxime. In all published HIV+ cases, the course of borreliosis did not differ from that of the HIV negative population and the prognosis in properly treated patients was good.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi Group; Cefotaxime; Cerebrospinal Fluid; HIV Infections; HIV-1; Humans; Lyme Neuroborreliosis; Male; Middle Aged; Treatment Outcome

Topics: Adult; Bioprosthesis; Cefotaxime; Diuretics; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Heart Valve Prosthesis; Hepatitis C, Chronic; HIV Infections; Humans; Immunocompromised Host; Klebsiella; Klebsiella Infections; Male; Postoperative Complications; Pulmonary Valve; Staphylococcal Infections

Pasteurella multocida is a major pathogen in local wound infections due to animal bites. Pneumonia and bacteremia are less frequent and usually associated with local or general impairment of host defenses. Scarce reports exist about Pasteurella multocida infections in HIV infected patients. We report here a case of hypoxemic pneumonia and bacteremia due to Pasteurella multocida revealing an HIV infection in a young man.

Topics: Adult; Amoxicillin; Animals; Anti-Infective Agents; Bacteremia; Bites and Stings; Cats; Cefotaxime; Cephalosporins; HIV Infections; HIV Seropositivity; Humans; Male; Pasteurella Infections; Pasteurella multocida; Pefloxacin; Penicillins; Pneumonia, Bacterial; Time Factors

Topics: Adult; Bacteremia; Cefotaxime; Cloxacillin; Drug Resistance, Microbial; Drug Therapy, Combination; Endocarditis, Bacterial; Escherichia coli; Escherichia coli Infections; Fatal Outcome; Female; HIV Infections; Humans; Injections, Intravenous; Male; Substance Abuse, Intravenous; Tobramycin; Urinary Tract Infections

Topics: Cefixime; Cefotaxime; Ceftriaxone; Gonorrhea; HIV Infections; Humans; Sexually Transmitted Diseases