ro13-9904 and Acquired-Immunodeficiency-Syndrome

Topics: Acquired Immunodeficiency Syndrome; Anti-Bacterial Agents; Antiviral Agents; Ceftriaxone; Chlamydia trachomatis; Coinfection; Colonoscopy; Cytomegalovirus; DNA, Bacterial; Doxycycline; Drug Therapy, Combination; Granuloma; Humans; Intestinal Mucosa; Male; Middle Aged; Neisseria gonorrhoeae; Proctitis; Rectum; Sexually Transmitted Diseases; Treatment Outcome; Valganciclovir

BACKGROUND Parainfluenza viruses (PIV) are known to cause mild respiratory tract infections in immunocompetent patients but can cause severe infections in immune-compromised patients such as transplant recipients and children with HIV. PIV infection in HIV-infected adults has rarely been reported. We report a case of PIV pneumonia in an adult with AIDS who was successfully treated with oral ribavirin. CASE REPORT A 64-year-old man with history of acquired immune deficiency syndrome (AIDS) was admitted to the hospital with shortness of breath that began 3 days before. He was in respiratory distress and required mechanical ventilation on arrival. A bronchoalveolar lavage (BAL) culture was positive for Hemophilus influenzae and a respiratory viral panel was positive for Parainfluenza virus. The patient was initially started on Cefepime and Trimethoprim- Sulfamethoxazole and later changed to Ceftriaxone based on culture results. As the patient's condition did not improve after 48 h, oral ribavirin was added to treat PIV. The patient subsequently improved and was extubated after 72 h. CONCLUSIONS Oral ribavirin can have a beneficial effect in AIDS patients who have PIV-associated pneumonia. Further investigation of the benefit of oral ribavirin in similar cases is warranted.

Topics: Acquired Immunodeficiency Syndrome; Anti-Bacterial Agents; Antiviral Agents; Ceftriaxone; Coinfection; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Middle Aged; Paramyxoviridae Infections; Pneumonia, Viral; Respiration, Artificial; Respiratory Distress Syndrome; Ribavirin

Human immunodeficiency virus (HIV) infection can cause a broad spectrum of clinical manifestations, ranging from an asymptomatic carrier state to severe immunodeficiency. The most common renal lesion, HIV-associated nephropathy (HIVAN), is a sclerosing glomerulopathy. However, potentially reversible causes of renal disease in HIV-infected patients should also be considered. We describe two cases of patients with acquired immune-deficiency syndrome (AIDS) who presented with rapidly progressive renal failure but were found to have reversible etiologies. The first case was found to have syphilis and the second, disseminated histoplasmosis; their renal injury resolved after initiation of a third-generation cephalosporin antibiotic and amphotericin B, respectively.

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Associated Nephropathy; Amphotericin B; Biopsy; Ceftriaxone; Histoplasmosis; Humans; Kidney; Male; Neurosyphilis

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Cellulitis; Enterobacteriaceae; Enterobacteriaceae Infections; Fatal Outcome; Female; Humans

We present a case of cerebral nocardiosis in a patient with AIDS. Space-occupying lesions were identified using magnetic resonance imaging (MRI) and white cell scanning. Nocardia asteroides was isolated from blood cultures. The patient's response to treatment with amikacin, imipenem and ceftriaxone was followed clinically and radiologically. When he died 6 months later, N. asteroides was isolated at post-mortem from a cerebral abscess. Although cerebral infections associated with the infiltration of neutrophils are rare in patients with AIDS, this case demonstrates that indium-labelled neutrophils can be used to identify a brain abscess and monitor its response to antimicrobial therapy.

Topics: Acquired Immunodeficiency Syndrome; Adult; Amikacin; Anti-Bacterial Agents; Brain Abscess; Ceftriaxone; Cephalosporins; Drug Therapy, Combination; Humans; Imipenem; Magnetic Resonance Imaging; Male; Nocardia asteroides; Nocardia Infections; Radionuclide Imaging; Thienamycins

Topics: Acquired Immunodeficiency Syndrome; Anemia, Hemolytic; Ceftriaxone; Cephalosporins; Child; Fatal Outcome; Hemolysis; HIV-1; Humans; Infusions, Intravenous; Male

We report the case of a patient with Aids, Kaposi's sarcoma and a systemic nocardial infection. After surgical drainage and adequate antibiotic treatment the infection was cured. Under secondary antimicrobial prophylaxis no relapse has occurred to date. Generalized N. asteroides infections have been rarely described in patients with Aids and the possible reasons for this are discussed.

Topics: Acquired Immunodeficiency Syndrome; Amikacin; Ceftriaxone; Drug Therapy, Combination; Humans; Male; Middle Aged; Nocardia asteroides; Nocardia Infections; Sarcoma, Kaposi

Topics: Acquired Immunodeficiency Syndrome; Adult; Brain Abscess; Ceftriaxone; Humans; Male; Minocycline; Nocardia asteroides; Nocardia Infections

Topics: Acquired Immunodeficiency Syndrome; Adult; Ceftriaxone; Humans; Male; Middle Aged; Salmonella enteritidis; Salmonella Infections