我国农村HIV/AIDS高流行地区肠道寄生虫感染现况调查

目的了解我国农村HIV/AIDS高流行地区HIV和肠道寄生虫合并感染状况。方法采用横断面调查方法,在安徽省阜阳市2个自然村开展流行病学调查,检测居民HIV和寄生虫感染情况。结果共调查769人,其中720人参与了9种常见肠道寄生虫的检测,蛔虫、钩虫、鞭虫、华支睾吸虫、人芽囊原虫、蓝氏贾第鞭毛虫、阿米巴原虫、隐孢子虫、粪类圆线虫感染率分别为0.56%、4.03%、0.28%、0.42%、21.39%、3.89%、1.67%、4.44%、0。肠道蠕虫总感染率为4.72%,原虫总感染率为24.31%;贫血患病率为34.68%;HIV感染率为8.10%;HIV合并肠道蠕虫感染率为2.17%,合并肠道原虫感染率为28.26%,其中合并人芽囊原虫感染率为19.57%;HIV阳性和HIV阴性人群合并隐孢子虫感染率分别为13.04%和4.70%,两者差异有统计学意义(P<0.05)。结论当地肠道蠕虫感染率低,肠道原虫感染率高,HIV阳性人群对隐孢子虫易感性增高。     

2015年河南省秦巴山地生态区人体肠道寄生虫感染现状调查

目的　了解河南省秦巴山地生态区人体肠道寄生虫病流行现状,为该地区寄生虫病防治提供科学依据。方法　2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求进行抽样,选取河南省秦巴山地生态区8个县（市）的26个调查点进行土源性线虫、带绦虫和肠道原虫感染调查,采用改良加藤厚涂片法（Kato?Katz法）检测肠道蠕虫卵,采用试管滤纸培养法鉴别十二指肠钩虫与美洲钩虫,采用透明胶纸肛拭法检查3 ~ 6岁儿童蛲虫卵和带绦虫卵,采用碘液直接涂片法检测肠道原虫滋养体和包囊。分析不同人群肠道寄生虫感染情况及其相关影响因素。结果　共检查6 706人,检出8种寄生虫,其中蠕虫3种、原虫5种,肠道寄生虫总感染率为3.39%,蠕虫和原虫感染率分别为2.92%和0.49%,3 ~ 6岁儿童肛拭蛲虫感染率为3.93%。查出的3种蠕虫分别为蛔虫、蛲虫和枝双腔吸虫,其中蛲虫感染率最高,为2.68%（[χ2] = 306.362,P < 0.05）;5种原虫分别为哈门氏内阿米巴、结肠内阿米巴、微小内蜒阿米巴、蓝氏贾第鞭毛虫和人芽囊原虫,其中微小内蜒阿米巴感染率最高,为0.24%（[χ2] = 23.842,P < 0.05）。8个县（市）中蠕虫感染率最高的地区为汝阳县（13.47%）,主要为蛲虫感染;原虫感染率最高的地区为新安县（1.55%）,主要为微小内蜒阿米巴感染;各县（市）蠕虫（[χ2] = 357.525,P < 0.05）和原虫感染率（[χ2] = 38.795,P < 0.05）差异均有统计学意义。男、女性蠕虫感染率差异无统计学意义([χ2] = 0.034,P > 0.05),但男性肠道原虫感染率高于女性([χ2] = 12.946,P < 0.05)。0 ~ 9岁年龄组人群蠕虫感染率最高（6.60%）,以蛲虫感染为主([χ2] = 62.600,P < 0.05)。肠道寄生虫总感染率在各民族间差异无统计学意义（[χ2] = 0.212,P > 0.05）。蠕虫在学龄前儿童中感染率最高（8.43%）,主要为蛲虫感染;蛔虫感染主要发生于农民,感染率为0.31%;不同职业人群蠕虫感染率差异有统计学意义([χ2] = 84.333,P < 0.05)。文盲人群肠道寄生虫感染率最高（7.63%）,不同文化程度人群肠道寄生虫感染率差异有统计学意义([χ2] = 72.013,P < 0.05)。平原地区人群肠道蠕虫感染率高于丘陵和山区([χ2] = 11.690,P < 0.05)。低收入人群肠道蠕虫感染率最高,为10.32% ([χ2] = 244.999,P < 0.05);原虫感染率最高的人群为年人均收入6 000 ~ 7 999元的中等收入人群([χ2] = 24.749,P < 0.05)。饮用井水人群蠕虫感染率远高于饮用自来水人群([χ2] = 62.255,P < 0.05),未进行集体驱虫人群原虫感染率高于驱虫人群([χ2] = 5.235,P < 0.05)。结论　河南省秦巴山地生态区人体肠道寄生虫感染率呈明显下降趋势,儿童蛲虫感染应成为今后该地区寄生虫病防治的重点。     

2015年河南省淮阳丘陵生态区人体重点寄生虫病现状调查与分析

目的 了解河南省淮阳丘陵生态区人体肠道寄生虫病流行现状。方法 按照全国第三次人体重点寄生虫病调查方案及河南省的调查方案,在生态区的基础上,结合经济和地理条件进行分层整群抽样。对调查点常驻居民采用改良加藤法和碘液涂片法分别检查肠道蠕虫和原虫感染情况,3 ~ 6岁儿童用肛拭法检测蛲虫感染。结果 河南省淮阳丘陵生态区抽中9个县,26个调查点,共调查6 710人,其中 528名3 ~ 6岁儿童接受了蛲虫肛拭检查。共查出肠道寄生虫11种,总感染率1.65%,其中蠕虫5种,感染率1.07%;原虫6种,感染率0.61%;儿童肛拭阳性率3.79%。混合感染占0.10%,均为2虫种混合感染。主要肠道寄生虫为蛔虫 0.31%、人芽囊原虫0.28%和钩虫0.27%。儿童肛拭蛲虫感染率3.79%。原虫在各年龄组均有感染,9岁及以下人群发现的寄生虫感染种类最多,以蛲虫为主。经驱虫人群肠道寄生虫和土源性线虫感染率均较未驱虫人群低。结论 河南省淮阳丘陵生态区人体重点寄生虫感染率明显下降,应加强对学龄前儿童和学生的寄生虫病防治与监测工作。     

河南省人体重要寄生虫病流行现状调查与分析

目的掌握河南省人体重要寄生虫病流行现状。方法按照《全国人体重要寄生虫病现状调查》实施细则制定的方法和要求,抽取17个县51个调查点进行肠道寄生虫调查,10个县20个点进行旋毛虫病调查,10个县30个点进行囊虫病调查,5个县进行弓形虫病调查,1个县进行包虫病调查,2个县进行黑热病媒介白蛉调查。结果肠道寄生虫感染调查25 894人,总感染率为14.96%(3 873/25 894),其中蠕虫感染率为9.80%(2 537/25 894),原虫感染率为6.61%(1 609/24 348)。查出肠道寄生虫29种,其中蠕虫18种,原虫11种。人群血清学调查,旋毛虫、囊虫、包虫和弓形虫抗体阳性率分别为2.97%(300/1 0103)、0.05%(1/2 200)、0.60%(6/1 007)和4.64%(216/4 660);黑热病媒介调查2个县,发现2种白蛉,共317只,中华白蛉占98.42%(312/317)。结论河南省人群肠道寄生虫感染率较10年前显著下降,但不同地区流行情况仍有较大差异,低年龄组仍是寄生虫感染的高危人群。人群旋毛虫和囊虫感染率较低,弓形虫感染率相对较高,包虫病仅有局部发病灶点。     

黑龙江省寄生虫病调查

根据 1992年全国人体寄生虫分布调查结果 ,全省 2 6个县 (市 )调查 10 1个点的 5 2 131人。查见各种寄生虫感染者9136人 ,总感染率为 17.5 3% ;共查见寄生虫 17种 ,其中原虫 10种 ,蠕虫 7种。蛔虫、鞭虫、华支睾吸虫和蛲虫感染率分别为 10 .34%、0 .6 %、1.18%和 15 .95 %。从全国调查结果看 ,虽然我省的总感染率较低 ,但个别地区个别虫种的感染率仍很高。如五常县蛔虫感染率高达 4 2 .3% ,拜泉县蛲虫感染率高达 34.39%。华支睾吸虫全省平均感染率达1.18% ,泰来县宁姜乡的感染率高达 4 4 .0 1%。该次调查对囊尾蚴病采用查阅资料收集县级以上…     

广西白裤瑶地区居民肠道寄生虫感染现状调查

目的了解广西白裤瑶少数民族地区居民肠道寄生虫感染情况,为进一步防治策略制定和实施提供依据。方法收集白裤瑶聚居区居民的一般人口学情况,采集粪便标本,采用改良加藤厚涂片法和生理盐水涂片法对粪样进行检查。结果调查广西白裤瑶聚居地居民671人,肠道寄生虫感染386人,感染率57.53%,其中白裤瑶居民感染率71.02%。检出9种肠道寄生虫,钩虫感染率33.68%,蛔虫感染率24.89%,鞭虫感染率9.84%,人芽囊原虫感染率10.87%,蓝氏贾第鞭毛虫感染率1.15%,结肠内阿米巴原虫感染率4.45%,溶组织内阿米巴原虫感染率1.65%,其他寄生虫感染率0.33%。不同年龄、不同民族居民的感染率差异有统计学意义。结论肠道寄生虫感染仍是广西山区农村尤其是少数民族地区突出的公共卫生问题。     

河南省农村儿童肠道寄生虫病流行现状及影响因素分析

目的　了解河南省农村儿童肠道寄生虫病流行现状及影响因素。方法　2014–2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求,根据河南省不同生态区划分及经济水平确定调查县（市）,根据被调查县（市）地形和经济水平等因素分层,每层随机抽取1个乡（镇）、每个乡（镇）随机抽取1个自然村作为调查点,共选取35个县（市）的104个点开展儿童肠道寄生虫病现状调查。每个调查点至少收集250份被调查者的新鲜粪样,采用改良加藤厚涂片（Kato?Katz）法检查肠道蠕虫卵,采用试管滤纸培养法鉴别美洲钩虫与十二指肠钩虫,应用生理盐水和碘液直接涂片法查肠道原虫滋养体和包囊;同时对3 ~ 6岁儿童采用透明胶纸肛拭法检查蛲虫卵和带绦虫卵。结果　河南省农村儿童肠道寄生虫感染率为3.21%（214/6 671）,肠道蠕虫感染率（2.62%,175/6 671）高于原虫（0.60%,40/6 671）。共检出12种肠道寄生虫,其中肠道线虫4种、吸虫1种、原虫7种;所有检出虫种中以蛲虫感染率最高,为2.47%（161/6 671）。全省4个生态区中,秦巴山地生态区儿童肠道寄生虫感染率最高,为5.85%（90/1 538）。男、女儿童肠道寄生虫感染率差异无统计学意义（P > 0.05）,不同年龄组（[χ2] = 32.762,P < 0.05）和文化程度（[χ2] = 67.507,P < 0.05）儿童肠道寄生虫感染率差异均有统计学意义,且各年龄组均以蛲虫感染为主。多因素非条件logistic回归分析结果显示,文化程度高、无害化厕所覆盖率高、饮用自来水及集体驱虫是儿童感染肠道寄生虫的保护因素。本次调查河南省农村儿童肠道寄生虫总感染率明显低于首次全国人体寄生虫分布调查和全国人体重要寄生虫病现状调查中河南省的相关数据,呈逐渐下降趋势。结论　河南省农村儿童肠道寄生虫感染率呈明显下降趋势,蛲虫应成为今后河南省农村儿童肠道寄生虫病的防治重点。     

河南省农村儿童肠道寄生虫病流行现状及影响因素分析

目的　了解河南省农村儿童肠道寄生虫病流行现状及影响因素。方法　2014–2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求，根据河南省不同生态区划分及经济水平确定调查县（市），根据被调查县（市）地形和经济水平等因素分层，每层随机抽取1个乡（镇）、每个乡（镇）随机抽取1个自然村作为调查点，共选取35个县（市）的104个点开展儿童肠道寄生虫病现状调查。每个调查点至少收集250份被调查者的新鲜粪样，采用改良加藤厚涂片（Kato?Katz）法检查肠道蠕虫卵，采用试管滤纸培养法鉴别美洲钩虫与十二指肠钩虫，应用生理盐水和碘液直接涂片法查肠道原虫滋养体和包囊；同时对3 ~ 6岁儿童采用透明胶纸肛拭法检查蛲虫卵和带绦虫卵。结果　河南省农村儿童肠道寄生虫感染率为3.21%（214/6 671），肠道蠕虫感染率（2.62%，175/6 671）高于原虫（0.60%，40/6 671）。共检出12种肠道寄生虫，其中肠道线虫4种、吸虫1种、原虫7种；所有检出虫种中以蛲虫感染率最高，为2.47%（161/6 671）。全省4个生态区中，秦巴山地生态区儿童肠道寄生虫感染率最高，为5.85%（90/1 538）。男、女儿童肠道寄生虫感染率差异无统计学意义（P > 0.05），不同年龄组（[χ2] = 32.762，P < 0.05）和文化程度（[χ2] = 67.507，P < 0.05）儿童肠道寄生虫感染率差异均有统计学意义，且各年龄组均以蛲虫感染为主。多因素非条件logistic回归分析结果显示，文化程度高、无害化厕所覆盖率高、饮用自来水及集体驱虫是儿童感染肠道寄生虫的保护因素。本次调查河南省农村儿童肠道寄生虫总感染率明显低于首次全国人体寄生虫分布调查和全国人体重要寄生虫病现状调查中河南省的相关数据，呈逐渐下降趋势。结论　河南省农村儿童肠道寄生虫感染率呈明显下降趋势，蛲虫应成为今后河南省农村儿童肠道寄生虫病的防治重点。     

云南省藏东-川西生态区人体重点寄生虫病流行现状调查

为了解云南省藏东-川西生态区人体重点寄生虫病流行现状,于2015年根据《第三次全国人体重点寄生虫病现状调查实施细则》的要求,选取云南省藏东-川西生态区的香格里拉市、贡山县开展人体重点寄生虫病调查,采用改良加藤厚涂片法(一粪二检)检测肠道蠕虫卵。钩虫卵阳性粪样(一粪一检)采用试管滤纸培养法进行钩蚴培养,鉴别钩虫种类。采用碘液和生理盐水直接涂片法检查原虫包囊和滋养体。3～6岁儿童加做透明胶纸肛拭法检查蛲虫卵和带绦虫卵。结果显示,共调查香格里拉市和贡山县5个村1 271人,发现肠道寄生虫感染458例,总感染率为36.0%。共检出肠道寄生虫12种,其中蠕虫5种,原虫7种。2种及以上混合感染的肠道寄生虫、蠕虫、原虫分别占15.9%(202/1 271)、 15.1%(192/1 271)、 0.2%(2/1 271)。土源性线虫总感染率为31.9%(406/1 271),其中鞭虫感染率最高,为23.1%(294/1 271)。贡山县土源性线虫感染率50.0%(383/764)高于香格里拉市的4.5%(23/507)(P 0.05)。原虫总感染率为5.9%(75/1 271),其中人芽囊原虫感染率最高(2.2%, 28/1 271)。香格里拉市原虫感染率为10.1%(51/507),高于贡山县的3.1%(24/764)(P 0.05)。土源性线虫感染主要以轻度为主,轻、中、重度感染构成比分别为78.7%(509/647)、 19.3%(125/647)、 2.0%(13/647)。男性和女性肠道寄生虫感染率分别为36.3%(206/567)和35.8%(252/704)。0～9岁年龄组肠道寄生虫感染率最高,为50.0%(95/190)。学龄前儿童肠道寄生虫感染率最高,为50.0%(84/168)。高中、中专文化人群肠道寄生虫和土源性线虫感染率最高,均为41.2%(14/34)。独龙族肠道寄生虫感染率最高,为84.0%(225/268)。不同年龄组、不同职业、不同文化程度和不同民族间感染率差异均有统计学意义(P 0.05)。云南省藏东-川西生态区香格里拉市、贡山县人体重点寄生虫感染率仍较高,应加强对农民、学生、妇女和儿童等重点人群寄生虫病防治。     

博乐市学龄前儿童、青少年肠道寄生虫病的调查与防治

自1996年5月至8月,在博乐市分别进行了学前儿童、青少年肠道寄生虫本底调查和驱虫复查,共调查2 180人,寄生虫感染者607人,总感染率为27.84％(607/2 180)。查见人体寄生虫10种,以蛲虫感染率为最高16.24％,依次为蓝氏贾第鞭毛虫7.29％,微小膜壳绦虫3.12％,鞭虫1.88％,蛔虫1.56％。集体驱虫的受治率98.33％(22 490/22 873),驱虫后寄生虫感染率为13.60％(288/2 117)。一次集体驱虫后,寄生虫总感染率下降了51.15％,其中蠕虫、原虫和绦虫感染下降率依次分别为61.73％,23.52％和20.25％,表明对肠道蠕虫的驱虫效果显著,取得了明显的社会效益。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.