Isolated pulmonary lymphoma in a patient with acquired immunodeficiency syndrome

We report the case of a male patient with AIDS who had been hospitalized for various opportunistic infections, from which he recovered, and was readmitted on account of a round opacity in the lower lobe of his right lung. There was no evidence of extrapulmonary pathology. Transtracheal aspiration, alveolar lavage and transbronchial biopsy failed to identify the lesion. Lung biopsy after thoracotomy resulted in a diagnosis of malignant lymphoma type B with anti-IgA and anti-kappa antibodies. Despite chemotherapy the patient died within one month, the lymphoma having spread to both lungs.     

Hyperviscosity syndrome in a patient with acquired immunodeficiency syndrome

The hyperviscosity syndrome is most commonly seen in association with monoclonal gammopathies and has only rarely been described in association with polyclonal hypergammaglobulinemia. We have recently seen a patient with known acquired immunodeficiency syndrome who presented with the hyperviscosity syndrome in the setting of polyclonal hypergammaglobulinemia. To our knowledge, this is the first reported case of a patient with the acquired immunodeficiency syndrome and the hyperviscosity syndrome. The case is presented and the pathogenesis and implications of this diagnosis are discussed.     

Rectal leishmaniasis in a patient with acquired immunodeficiency syndrome

A severe rectal lesion due to Leishmania infection is described in an American-born homosexual man with the acquired immunodeficiency syndrome. The infection, which may have been venereally transmitted, responded to treatment with amphotericin B. There was no evidence of visceral leishmaniasis. The contribution of the patient's immunodeficiency to the development of the atypical cutaneous leishmanial lesion is unclear. The case may foretell increasing problems with protozoan infections in AIDS as the epidemic spreads to areas with endemic protozoan diseases.     

Toxoplasma peritonitis in a patient with acquired immunodeficiency syndrome

Toxoplasma gondii was identified in a stained slide preparation of, and isolated from, peritoneal fluid specimens obtained from a patient with the acquired immunodeficiency syndrome (AIDS). At the time of admission to the hospital, the patient's serologic tests were positive for Toxoplasma. Toxoplasma was isolated from samples of the patient's blood by mouse inoculation. Findings of newly developed methods for diagnosis of the presence of T gondii in body fluids by assay for Toxoplasma-specific antigen and by use of a DNA probe were positive.     

Generalised tuberculosis in a patient with acquired immunodeficiency syndrome

We describe a heroin addict who presented with cellular immunodeficiency, generalised tuberculosis, and pneumonia caused by Pneumocystis carinii, and discuss the risk of these associations.     

Pyomyositis in a patient with the acquired immunodeficiency syndrome

Pyomyositis is an acute bacterial infection of skeletal muscle. It is a common disease in the tropics; fewer than 50 cases of pyomyositis have been reported in the continental United States. Most patients are healthy males, although the disease has been reported in diabetics and in the immunocompromised. This article presents the first detailed known reported case of pyomyositis in a patient with the acquired immunodeficiency syndrome; Staphylococcus aureus was the etiologic agent.     

Disseminated strongyloidiasis in a patient with acquired immunodeficiency syndrome

We report a case of Strongyloides stercoralis hyperinfection in a Spanish patient who had never traveled to an endemic area and in whom HIV infection and long-term immunosuppressive treatment most likely contributed to the dissemination of strongyloidiasis.     

Sarcoidosis after antiretroviral therapy in a patient with acquired immunodeficiency syndrome.

A 53-year-old man with acquired immunodeficiency syndrome (AIDS) developed clinical and radiological features compatible with sarcoidosis 14 months after starting highly active antiretroviral therapy (HAART). The CD4 lymphocyte count had increased from 5 cells/mm(3) to 235 cells/mm(3) with HAART. Transbronchial lung biopsy showed nonnecrotizing granulomas. All studies for an infectious etiology were negative. His condition improved after treatment with corticosteroids. To our knowledge, this is the fifth case report of sarcoidosis occurring after initiation of antiretroviral therapy for AIDS.     

Sarcoidosis in a patient with acquired immunodeficiency syndrome treated with interleukin-2.

Concomitant human immunodeficiency virus (HIV) infection and sarcoidosis is rare. Sarcoidlike reactions could belong to the "highly active antiretroviral therapy (HAART)-induced immune restitution syndrome." We report a case of sarcoidosis beginning after 2 months of interleukin-2 (IL-2) therapy in a patient with HIV who had undetectable plasmatic viral load under HAART and we discuss possible mechanisms.     

Strongyloides stercoralis hyperinfection in a patient with acquired immunodeficiency syndrome

Strongyloides stercoralis hyperinfection is a rare but know complication in patients with intestinal parasitism. Immunosuppressive therapy and acquires immunodeficiency syndrome (AIDS) are major risk factors for dissemination. Diagnosis requires identification of larvae in body fluids or biopsy and the mortality rates can be as high as 80%. The enteric bacteria are carried by invasive larvae and this can result in septicemia, pneumonia, meningitis, and disseminated bacterial infection in many parts of the body. We present a case of Strongyloides stercoralis hyperinfection complicated by Escherichia coli bacteraemia in a 45-year-old man African with AIDS.     

Acute tuberculous pancreatitis in a patient with acquired immunodeficiency syndrome

The authors report a case of tuberculous pancreatitis in a 29 year old Zairan man. Serum antibodies against HIV were positive. T-lymphocyte analysis revealed 18/mm3 OKT4 with an OKT4/OKT8 ratio of 0.43. The initial examination suggested severe acute pancreatitis. Only the postmortem histopathological analysis revealed tuberculous pancreatitis, showing several miliary lesions with caseous necrosis and acid fast bacili (Ziehl stain). Subsequently, cultures (sputum, bronchoalveolar lavage, pleural effusion, ascitis) of bacili identified Mycobacterium tuberculosis. Tuberculous pancreatitis should be considered in subjects with acute pancreatitis according to the epidemiological context, once the most frequent causes of pancreatitis have been eliminated.     

Widespread cytomegalovirus gastroenterocolitis in a patient with acquired immunodeficiency syndrome

This case report documents extensive gastrointestinal cytomegalovirus infection in a patient with acquired immunodeficiency syndrome, presenting as diarrhea and involving stomach, duodenum, and colon. Endoscopic biopsy specimens and cultures were essential to make the diagnosis and to distinguish the illness from inflammatory bowel disease. A careful search for other potential pathogens was made as well. The discussion includes a review of literature regarding cytomegalovirus involvement of the gastrointestinal tract.     

Cytomegalovirus peritonitis in a patient with the acquired immunodeficiency syndrome

Summary Peritonitis has been reported infrequently in patients with the acquired immunodeficiency syndrome (AIDS). Intestinal or colonic perforation resulting from cytomegalovirus (CMV) enteritis is the most common cause of peritonitis in these patients. We report a patient with CMV peritonitis occurring in the absence of perforation (primary peritonitis) to alert physicians to this potentially treatable disorder.