AIDS-Related Opportunistic Infections ; complications ; microbiology ; Acquired Immunodeficiency Syndrome ; complications ; microbiology ; Adult ; Humans ; Male ; Penicillium ; pathogenicity ; Pharyngeal Neoplasms ; complications ; microbiology ; Pharynx ; microbiology ; pathology

70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study. M. tuberculosis and non-tuberculosis mycobacterium (NTM) were identified by using multi-locus PCR. M. tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards. Meanwhile, the drug susceptibilities of the strains to the four first-line anti TB drugs (rifampin, isoniazid, streptomycin, and ethambutol) and the four second-line anti-TB drugs (capreomycin, kanamycin, ofloxacin, and ethionanide) were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.
AIDS-Related Opportunistic Infections ; microbiology ; Antitubercular Agents ; pharmacology ; China ; Humans ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; classification ; drug effects ; isolation & purification ; Phylogeny ; Tuberculosis ; complications ; microbiology

OBJECTIVETo analyze Helicobacter pylori infection in the gastric mucosa of patients with HIV/AIDS in different clinical stages.

METHODSThis study involved 170 patients with HIV/AIDS and 34 HIV-negative patients. All the patients underwent upper endoscopy and antral gastric biopsy to determine the status of Helicobacter pylori infection using aniline red staining and rapid urease test. The patients with HIV/AIDS were stratified based on CD4(+)T lymphocyte counts and clinical setting into asymptomatic HIV infection (A1, A2) group, symptomatic HIV infection (B1, B2) group and AIDS (A3, B3, C1-3) group.

RESULTSThe prevalence of Helicobacter pylori infection in HIV/AIDS patients was 16.5% (28/170), and in the 3 groups classified, the infection rates were 23.4% (11/47), 14.0% (8/57), and 13.6% (9/66), respectively; the infection rate was 47.1% (16/34) in the control group. Helicobacter pylori infection rate in the gastric mucosa of the patients with HIV/AIDS in different clinical stages was significantly lower than that of the control group (P<0.05); the infection rates in symptomatic HIV-infected (B1, B2) group and AIDS (A3, B3, C1-3) group were significantly lower than that in asymptomatic HIV-infected (A1, A2) group (P<0.05).

CONCLUSIONThe low Helicobacter pylori infection rate in HIV/AIDS patients may result from severe immunodeficiency in the gastric mucosa.

AIDS-Related Opportunistic Infections ; microbiology ; pathology ; Acquired Immunodeficiency Syndrome ; microbiology ; pathology ; Adult ; Female ; Gastric Mucosa ; microbiology ; Gastroscopy ; HIV Infections ; microbiology ; pathology ; Helicobacter Infections ; epidemiology ; pathology ; Helicobacter pylori ; Humans ; Male ; Middle Aged

OBJECTIVETo study the clinicopathologic features of acquired immunodeficiency syndrome (AIDS)-related lymphadenopathy and to elucidate the salient features helpful in achieving a correct pathologic differentiated diagnosis.

METHODSEighteen cases of AIDS-related lymphadenopathy were retrieved from the files of the First Affiliated Hospital of Guangxi Medical University from 2001 to 2004. Histochemical stains, including periodic acid-Schiff, acid-fast, Giemsa, Grocott stains and immunohistochemistry (EnVision method), were used to detect the presence of pathogens in tissue sections and classify them.

RESULTSFifteen of the 18 cases (83%) were stage 4 (i.e. follicular and lymphocytic depletion). Twelve cases were co-infected with Penicillium marneffei and 4 other cases with Mycobacterium, and no pathogen was found in 1. The remaining patient was complicated with diffuse large B-cell lymphoma.

CONCLUSIONSWhen presented in early stages, AIDS-related lymphadenopathy may be overlooked, especially in routine pathology practice. Awareness of the entity in patients with persistent fever and generalized lymphadenopathy is thus crucial. Florid infection with Penicillium marneffei is also considered as an important predictor for underlying AIDS. Thorough understanding of morphologic features of AIDS-related lymphadenopathy, including possible co-infection, is essential in arriving at the correct diagnosis.

AIDS-Related Complex ; microbiology ; pathology ; AIDS-Related Opportunistic Infections ; microbiology ; pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, AIDS-Related ; pathology ; Lymphoma, Large B-Cell, Diffuse ; pathology ; Male ; Middle Aged ; Mycobacterium ; isolation & purification ; Mycobacterium Infections ; microbiology ; pathology ; Mycoses ; microbiology ; pathology ; Penicillium ; isolation & purification ; Retrospective Studies

Histoplasmosis is a very rare disease in Korea. Clinical manifestations are very similar to those of tuberculosis. This is the first case report of combined disseminated histoplasmosis and tuberculosis in a patient with HIV infection in Korea. A 42-year-old Korean with Acquired Immunodeficiency Syndrome (AIDS) was diagnosed with tuberculosis. He had lived in Guatemala for the past five years. Upon diagnosis of disseminated tuberculosis with HIV infection, he was treated with anti-tuberculosis medications and anti-retroviral agents. Fever, weakness, hepatosplenomegaly and pancytopenia were persistent despite treatment. The patient's history of living in Guatemala caused us to seek opportunistic infectious organisms other than tuberculosis. Bone marrow aspiration and biopsy were performed and the result revealed numerous intracellular organisms consistent with Histoplasma capsulatum; therefore, the diagnosis of disseminated histoplasmosis was made.
AIDS-Related Opportunistic Infections/microbiology ; Acquired Immunodeficiency Syndrome/complications/pathology ; Adult ; Bone Marrow/microbiology/pathology ; HIV Infections/*complications/drug therapy ; Histoplasma/isolation & purification ; Histoplasmosis/complications/*diagnosis/microbiology ; Humans ; Male ; Thorax/microbiology/pathology/radionuclide imaging ; Tuberculosis/complications/*diagnosis

AIDS-Related Opportunistic Infections ; diagnosis ; microbiology ; Acquired Immunodeficiency Syndrome ; diagnosis ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Female ; Humans ; Immunohistochemistry ; Male ; Methenamine ; Pneumocystis carinii ; isolation & purification ; Pneumonia, Pneumocystis ; diagnosis ; microbiology ; Polymerase Chain Reaction ; Silver Staining ; methods

A 36-year-old homosexual Mexican man was admitted to our hospital, with a 30-day history of fever and headache. Upon cerebrospinal fluid examination, the patient's white blood cell count was 1,580/L, total protein was 26 mg/dL, sugar was 17 mg/dL, and his intracranial pressure was 23 cmH2O. The patient was diagnosed with HIV (Human Immunodeficiency Virus) infection by serum Western blotting. Cryptococcus neoformans was isolated in cultures of the patient's blood and cerebrospinal fluids. Chest computerized tomography revealed diffuse reticulonodular infiltration and a ground-glass appearance in both perihilar regions, suggestive of either Pneumocystis carinii pneumonia or cryptococcal pneumonia. On the patient's 6th day in our hospital, bronchoalveolar lavage and transbronchial lung biopsy were conducted via bronchoscopy, and a pathologic examination of lung biopsy specimens revealed signs of cryptococcal pneumonia. This patient died on his 14th day in our hospital, as the result of acute respiratory failure, associated with cryptococcal pneumonia and disseminated cryptococcosis.
Respiratory Insufficiency/*diagnosis/etiology/*microbiology ; Pneumonia/*diagnosis/*microbiology ; Male ; Humans ; Fatal Outcome ; Cryptococcus neoformans/*isolation & purification ; Cryptococcosis/*diagnosis/microbiology ; Bronchoalveolar Lavage ; Blotting, Western ; Adult ; Acute Disease ; AIDS-Related Opportunistic Infections/complications/*microbiology

OBJECTIVETo observe the effect of xiaomi granules (XMG) for treatment of HIV/AIDS oral candidiasis.

METHODSForty patients in the treated group were treated by XMG and 40 patients in the control group were treated with anticandine. The therapeutic course for both groups was two weeks. Changes of clinical symptoms, oral candida microscopic examination and cultured before and after treatment as well as the safety of treatment were observed, and a follow-up study was implemented two weeks after ending medication to compare the relapse rate between groups.

RESULTSSymptoms as oral greasy-sticky, thirsty, asthenia, abdominal distension and anorexia were improved after treatment in both groups (P < 0.05). The improvements of oral greasy-sticky and thirsty in the treated group were better than those in the control group (P < 0.05). The effective rate and relapse rate in the treated group was 90.0% (36/40) and 11.1% (4/36) respectively, while in the control group, 72. 5% (29/40) and 31.0% (9/29) respectively.

CONCLUSIONXMG could improve the clinical symptoms with high efficacy and low relapse rate, shows a better effect than that of anticandine in treating HIV/AIDS oral candidiasis.

AIDS-Related Opportunistic Infections ; drug therapy ; Acquired Immunodeficiency Syndrome ; microbiology ; Adult ; Candidiasis, Oral ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; HIV Infections ; microbiology ; Humans ; Male ; Middle Aged ; Treatment Outcome

A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterial (NTM) infections in HIV-infected patients. A total of 627 patients' data were reviewed, and 102 (16.3%) patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection (48/102, 47.1%). The overall rates of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.
AIDS-Related Opportunistic Infections ; epidemiology ; microbiology ; Adult ; Beijing ; Coinfection ; Extensively Drug-Resistant Tuberculosis ; epidemiology ; microbiology ; Female ; HIV Infections ; epidemiology ; microbiology ; Hospitals, Urban ; Humans ; Male ; Mycobacterium Infections, Nontuberculous ; epidemiology ; microbiology ; Mycobacterium tuberculosis ; isolation & purification ; Nontuberculous Mycobacteria ; isolation & purification ; Prevalence ; Retrospective Studies ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; microbiology

OBJECTIVESTo elucidate the etiology, pathohistology, clinical characteristic and differential diagnosis, reduce missed diagnosis and improve the early detection and treatment of Penicillium Marneffei infection, by means of this case report and literature review.

METHODSA patient hospitalized Penicillium Marneffei infection were presented here, together with 27 cases in the literature, among which 10 patients had complications of AIDS and 5 with other diseases.

RESULTSPenicillium Marneffei is a temperature-sensitive, two-phase fungus, which can infect healthy and immunocompromised subjects. The common symptoms are lymphadenopathy and infection of the lung. The infection may be local or diffuse, involving the intestinal tract, soft tissue, bone, liver, spleen and bone marrow etc. The lesion can be classified into the granuloma type, suppurative type and anergy/necrosis type histologically. The yeast-like fungus were mainly found in the cytoplasm of macrophages, which were demonstrated by PAS and Giemsa staining. The wine red color developed on the culture confirms the diagnosis.

CONCLUSIONSThe diagnosis of Penicillium Marneffei infection should be considered when tuberculosis is suspected but not confirmed, and if the patient has a history of having lived or traveled in Southeast Asia, is anemic or resistant to anti-tuberculosis treatment. The major differential diagnosis is histoplasmosis. Early administration of anti-fungus drugs is essential for recovery.

AIDS-Related Opportunistic Infections ; diagnosis ; drug therapy ; microbiology ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Drug Therapy, Combination ; Humans ; Itraconazole ; therapeutic use ; Male ; Middle Aged ; Mycoses ; diagnosis ; drug therapy ; microbiology ; Penicillium ; isolation & purification