trimethoprim--sulfamethoxazole-drug-combination and Sarcoma--Kaposi

This review paper is divided into three parts. The first two parts are devoted to an analytical description of the clinical, diagnostic, prognostic and therapeutic aspects of the various bronchopulmonary and pleural lesions observed in AIDS. The third part presents an overall view of the main diagnostic and therapeutic approaches in the main clinical situations covering all respiratory disorders.

Topics: Acquired Immunodeficiency Syndrome; Humans; Lymphoma, Non-Hodgkin; Opportunistic Infections; Pentamidine; Pneumonia, Pneumocystis; Respiratory Tract Infections; Sarcoma, Kaposi; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Antibodies, Viral; B-Lymphocytes; beta 2-Microglobulin; Biopterins; Candidiasis, Oral; Drug Combinations; Humans; Interferon Type I; Lymphocyte Activation; Neopterin; Pneumonia, Pneumocystis; Retroviridae; Sarcoma, Kaposi; Sulfamethoxazole; T-Lymphocytes, Regulatory; Thymalfasin; Thymosin; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The aetiology of diarrhoea in a patient in Cuba with HIV was investigated. Although molecular diagnostics are still not used in many under-resourced settings, here traditional methods were supported by use of PCR. This approach enabled detection of a dual infection (Cystoisospora belli and Enterocytozoon bieneusi), the latter of which was not identified by microscopy with Didier's trichromic staining.

Topics: Adult; Anti-Infective Agents; Coccidiosis; Cuba; Diarrhea; Enterocytozoon; HIV Infections; Humans; Immunocompromised Host; Male; Microsporidiosis; Molecular Diagnostic Techniques; Polymerase Chain Reaction; Sarcocystidae; Sarcoma, Kaposi; Trimethoprim, Sulfamethoxazole Drug Combination

Diarrhea in an immunocompromised patient has a broad infectious differential. Diagnosis is difficult despite advances in diagnostic modalities. We report a case of a 45-year-old Nigerian woman who immigrated to the United States 2 years ago. She presented to the hospital with gastrointestinal bleeding, newly diagnosed HIV, and disseminated Kaposi sarcoma. During hospitalization, the patient had an onset of watery diarrhea and high eosinophilia. Subsequent stool analysis using multi-parallel real-time quantitative polymerase chain reaction for 13 parasites was positive for Cystoisospora belli. The patient was treated with trimethoprim-sulfamethoxazole, but had relapsed disease when her antibiotics were stopped prematurely. After restarting trimethoprim-sulfamethoxazole, her diarrhea and eosinophilia improved, and she had undetectable Cystoisospora belli DNA on repeat stool quantitative polymerase chain reaction. This case highlights the importance of a thorough workup for diarrhea, including parasites, especially for immunocompromised patients. Antibiotic prophylaxis is recommended in patients with Cystoisospora belli and HIV/AIDS.

Topics: Anti-Infective Agents; Diarrhea; Eosinophilia; Female; Gastrointestinal Hemorrhage; HIV Infections; Humans; Immunocompromised Host; Isospora; Isosporiasis; Middle Aged; Sarcoma, Kaposi; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

A 36-year-old African American man with no medical history presented with a recent history of cough and dyspnoea. Initial chest imaging revealed diffuse bilateral lung infiltrates. A subsequent HIV test resulted positive, and he was presumptively diagnosed with AIDS, later confirmed by a CD4 of 88 cells/mm

Topics: Acquired Immunodeficiency Syndrome; Adult; Antiretroviral Therapy, Highly Active; Humans; Male; Pneumocystis carinii; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adult; Anti-HIV Agents; Anti-Infective Agents; CD4 Lymphocyte Count; Chemoprevention; Community-Acquired Infections; Cough; Dyspnea; Fatal Outcome; HIV Infections; Humans; Lymphatic Diseases; Lymphoma, Non-Hodgkin; Male; Medication Adherence; Pancytopenia; Pneumocystis carinii; Pneumonia, Pneumocystis; Radiography; Sarcoma, Kaposi; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Adult; Allied Health Personnel; Anti-Infective Agents; Child; Cross Infection; Drugs, Investigational; Female; HIV-1; Humans; Infections; Male; Neoplasms; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Substance-Related Disorders; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Viral Vaccines

Between 1983 and 1985, 71 patients with the acquired immunodeficiency syndrome (AIDS) were evaluated. Pulmonary manifestations were present in 42 patients (59%). Pneumocystis carinii pneumonia (PCP) was the most common pulmonary manifestation, present in 32 patients (45%). Other pulmonary findings were cytomegalovirus pneumonia (one patient), Candida pneumonia (one patient), cryptococcal pneumonia (one patient), bacterial pneumonia (three patients), nonspecific pneumonitis (three patients), Kaposi's sarcoma (one patient), and non-Hodgkin's lymphoma (one patient). The presenting features of PCP were reviewed and in seven patients the chest X-ray and blood gases were normal at the time of diagnosis of PCP. Bronchoscopy was a safe and useful technique for obtaining specimens for diagnosis promptly, and a combination of samples obtained by bronchial washings/brushings and transbronchial biopsy was found to give a higher diagnostic yield than any single sample. Drug side-effects were common during therapy, requiring change of therapy in 16 patients. At one month after diagnosis 16% of patients with PCP had died. PCP is a common pulmonary manifestation in patients with AIDS which is treatable and has an initially favourable outcome.

Topics: Acquired Immunodeficiency Syndrome; Adult; Bronchoscopy; Drug Combinations; Humans; Lung Diseases; Lung Neoplasms; Lymphoma, Non-Hodgkin; Male; Middle Aged; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Africa; Antibodies, Viral; Antiviral Agents; Deltaretrovirus; Drug Combinations; Enzyme-Linked Immunosorbent Assay; Female; Haiti; Homosexuality; Humans; Male; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Vaccination; Virus Replication

The cause of AIDS is unknown. In the absence of a specific etiologic agent or diagnostic test, a case can only be recognized when complications of the immune deficiency such as infection or Kaposi's sarcoma occur. Defective T-cell function is the principal immunologic defect; there are also defects, however, in B-cell function that may have some clinical significance. It has not yet been possible to reverse the immunologic deficiency, and this failure has been the principal prognostic factor in this illness. A number of the infectious complications of AIDS, however, can be diagnosed and successfully treated.

Topics: Acquired Immunodeficiency Syndrome; Adult; Bacterial Infections; Cytomegalovirus Infections; Drug Combinations; Female; Gastrointestinal Diseases; Herpes Simplex; Homosexuality; Humans; Male; Parasitic Diseases; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Virus Diseases

Topics: Acquired Immunodeficiency Syndrome; Drug Combinations; Humans; Immunotherapy; Pentamidine; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acquired Immunodeficiency Syndrome; Drug Combinations; Drug Eruptions; Humans; Pneumonia, Pneumocystis; Sarcoma, Kaposi; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination