Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area

Article Abstract:

The types of diseases that infect patients with acquired immunodeficiency syndrome (AIDS) are often a result of local patterns of disease occurrence. Nontyphoidal Salmonella frequently infects AIDS patients in North America and Western Europe, but infection with Salmonella typhi or Salmonella paratyphi has rarely been reported in persons infected with human immunodeficiency virus (HIV) who live in those regions. Typhoid and paratyphoid are endemic along the western coast of South America, and eight cases among HIV-infected patients in Lima, Peru are described. The decreased natural bacterial resistance among HIV-infected patients makes them more susceptible to S. typhi and S. paratyphi. The risk of infection is approximately the same as the 20-fold increase in risk for non-typhi Salmonella infections among HIV-infected patients in the United States. Because the majority of HIV-patients in this group were homosexual, it is possible that infection with typhoid or paratyphoid fever was caused by fecal-oral transmission, except that an increased rate of infection does not occur among HIV-negative homosexual men. The symptoms and response to therapy of HIV-infected patients or patients with lymphadenopathy are similar to those of the general population. For those with AIDS, the symptoms were unusual (ulcerative colitis, or severe diarrhea) and the response to treatment was not as good. The two who were followed-up for two months both relapsed and the two others died. The increased risk of typhoid and paratyphoid fever in HIV-infected patients in typhoid-endemic areas should be recognized. Additionally, a diagnosis of typhoid, especially when accompanied by severe or ulcerative diarrhea, should indicate the need to test for HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Peru, AIDS (Disease), Salmonellosis, Typhoid fever, Salmonella typhosa, Salmonella typhi

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Nonsteroidal anti-inflammatory drug nephrotoxicity: should we be concerned?

Article Abstract:

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been associated with various nephrotoxicity syndromes, or diseases affecting the kidneys. The most common disorder is renal insufficiency or impaired kidney function, which is caused by circulatory changes and is reversible. NSAIDs prevent the actions of prostaglandins, fatty acid compounds that have several biological functions, including effects on blood flow and coagulation. The effects of NSAIDs on prostaglandins may contribute to NSAID-related kidney abnormalities. The differences among various types of NSAIDs are discussed. Sulindac has a "renal-sparing" effect, or less toxic action on the kidney, because this NSAID preserves prostaglandin production in the kidney. Another NSAID, salsalate, prevents inflammation and has only weak inhibitory effects on prostaglandin at therapeutic doses. Recommendations are made for the clinical use of NSAIDs while taking these features into consideration. The differences between NSAIDs become important and must be considered with the use of increasing doses of NSAIDs and with increasing risk factors for NSAID-induced nephrotoxicity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Physiological aspects, Nonsteroidal anti-inflammatory drugs, Nonsteroidal anti-inflammatory agents, Prostaglandins, Kidney diseases

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