Abdominal mycobacterial infections in immunocompromised patients

Article Abstract:

Mycobacteria are a genus of acid-fast bacteria including species that cause leprosy and tuberculosis (TB). The AIDS (acquired immunodeficiency syndrome) epidemic has been largely responsible for an increased incidence of tuberculosis. There has also been an increase in tuberculosis occurring outside the lungs. A review was undertaken of mycobacterial cultures obtained from patients admitted to a major New York City Hospital. There were 21 patients found to have abdominal mycobacterial infections; they were 17 men and 4 women with an average age of 36 years. Fourteen patients either had AIDS or were at risk for AIDS (13 IV drug abusers, 1 homosexual). In the non-AIDS group, two patients were homeless people, two were immigrants from an area known to have TB, and one patient had undergone removal of the spleen. The most common symptom of the abdominal infections was abdominal pain (17 of 21 patients, or 81 percent), although absence of pain (four patients) and no abnormal abdominal findings on examination were not uncommon. There were 14 patients who had computed tomographic (CT) scans performed; all were abnormal and 9 (67 percent) suggested abdominal mycobacterial infection. In only four patients did the chest X-ray show the typical findings of TB, and seven patients had no evidence of TB. Acid-fast bacillus smears (a test for tuberculosis) were initially negative in 40 percent of patients who were later found to be positive. Ten patients (48 percent) required surgery, with one death postoperatively. The remaining patients were treated with antibiotics only; these patients usually had higher fevers. The one-year survival rate was only 66 percent due to the combination of diseases in these patients; average survival was 10.2 months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Infection, Tuberculosis, Mycobacterial infections, Mycobacterium infections, Abdomen

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Ganciclovir

Article Abstract:

Twenty to 25 percent of patients suffering from acquired immunodeficiency syndrome (AIDS), who are also infected with the cytomegalovirus, develop retinitis, or inflammation of the retina, the inner lining of the eye. A new drug called ganciclovir is now available to combat infection with cytomegalovirus, but it must be administered intravenously. In infected cells, ganciclovir is changed into an active form, which inhibits the replication or duplication of DNA, the genetic information of the cell, and causes cell death. Ganciclovir is excreted in the urine and can be given once or twice daily. The administration of ganciclovir results in brain levels between 25 and 75 percent of that in blood. Studies reported that 10 to 20 days of therapy with ganciclovir decreased retinitis in 86 percent of the patients treated. Other studies have since reported that there is greater improvement in retinitis if patients are treated with higher doses for two to three weeks and then given lower maintenance doses. Ganciclovir may also be effective in treating inflammation of the esophagus and colon in AIDS patients who are infected with cytomegalovirus. Adverse effects of ganciclovir include rash, confusion, and a decrease in the numbers of the white blood cells and platelets, which are required for blood clotting. In addition, continuous intravenous administration of ganciclovir is costly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Retinal diseases, Cytomegaloviruses, Cytomegalovirus

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Antiviral therapy for human papillomaviruses: rationale and prospects

Article Abstract:

Future therapies for the human papillomavirus (HPV), which produces a variety of warts, may include a vaccine against the virus or may target the reproductive and growth cycle of the virus. Genital HPV infections are implicated in cervical cancer. Researchers reviewed the current literature to present a descriptive overview of HPV, describe current therapies, and propose targets for future therapies. Warts on the hands, feet, genitals, and to a lesser extent in the throat and on the trunk of the body are common. Current therapy for warts includes surgical removal, freezing, burning, or the use of lasers. However, no current therapy targets the virus itself. The virus is small, produces only a few proteins, and relies on the host for much of its life cycle. Therapy could conceivably target one of the proteins responsible for reproduction or growth. Some studies indicate that researchers could develop a vaccine specific to HPV.

Papillomavirus infections

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