Immunocytochemical analysis of lymph node aspirates in patients with human immunodeficiency virus infection

Article Abstract:

In patients with human immunodeficiency virus (HIV) infection, the most frequent finding is generalized disease of the lymph nodes (lymphadenopathy). The cause of their lymphadenopathy is not always apparent, but may be follicular hyperplasia, malignant lymphoma, Kaposi's sarcoma, or mycobacterial infection. Immunocytochemical analysis allows differentiation between malignant and benign conditions by analysis of monoclonal activity. Reactivity of monoclonal antibodies is used to detect abnormal blood lymphocytes. The causes of the lymphadenopathy in 34 HIV-positive patients were investigated using immunocytochemical techniques with lymph node aspiration. Immunocytochemical analysis was performed and revealed 15 cases of follicular hyperplasia. In 11 of these aspirates, there was B cell predominance. Non-Hodgkin's lymphoma was found in 10 patients; of the 10, five had Burkitt's lymphoma and five had B cell immunoblastic lymphoma. These results were similar to the findings based on tissue biopsy, a more invasive diagnostic technique than lymph node aspiration with immunocytochemical analysis. Mycobacterial infections were found in two patients using each technique. Immunocytochemical analysis was less definitive in confirming Kaposi's sarcoma, and tissue biopsy was needed. It is concluded that much information can be derived from immunocytochemical analysis of lymph node aspirate without resorting to tissue biopsy. Especially with follicular hyperplasia, biopsy may not be needed. Both techniques used in combination yield the most definitive diagnosis of the cause of lymphadenopathy in HIV-positive patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Causes of, Immunocytochemistry, Lymphadenopathy

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Opportunistic protozoan infections in human immunodeficiency virus disease: review highlighting diagnostic and therapeutic aspects

Article Abstract:

Patients with AIDS or human immunodeficiency virus (HIV) infection are at great risk for developing opportunistic infections, because their immune function is impaired; some of the most severe infections are those caused by protozoan parasites. Many protozoan infections involve the intestines, while others infect other parts of the body such as the heart and lungs. A large number of parasitic protozoa have the potential to infect AIDS patients, and as time goes on it is expected that more and more types of protozoa will be identified as infectious agents in this population. Pneumocystis carinii is an organism that some scientists consider a protozoan, while others consider it a fungus. Pneumonia caused by Pneumocystis carinii is the first complication of AIDS for 60 percent of the patients, and it eventually affects 85 percent of people with AIDS. This organism most commonly infects the lungs but has also been found in the liver, heart, skin and small intestine. The disease known as toxoplasmosis, caused by Toxoplasma gondii, may affect as many as 70 percent of AIDS patients. Encephalitis, an inflammation of the brain which is often fatal, may result from toxoplasmosis in AIDS patients, as can infections of the heart, lungs, and intestines. Giardiasis, caused by Giardia lamblia, is widespread among homosexual men and in the population infected with HIV; it may cause diarrhea or no symptoms at all. Recommended techniques for diagnosing these and other protozoan infections affecting HIV-infected people are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Protozoa, Protozoans, Parasitic diseases

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Strongyloides stercoralis hyperinfection in an HIV positive patient

Article Abstract:

The case report is presented of a 25-year-old man, positive for infection with human immunodeficiency virus (HIV, which causes AIDS), who became infected with Strongyloides stercoralis, a parasite. While healthy people are not usually susceptible to infection with this agent, those whose immune systems are compromised can become seriously ill. The patient's symptoms began three years after his diagnosis with HIV infection, when he developed weight loss and loose bowel movements. Samples of fecal material grown in culture were found to contain Strongyloides stercoralis. He was treated with the drug thiabendazole and the symptoms disappeared, but a relapse occurred two months later. The same medication was given and the infection cleared again. One month later, the patient was hospitalized with abdominal pain, vomiting, weight loss, constipation, and a skin rash. After a series of treatments, he experienced heart and lung failure, and died after resuscitation efforts failed. The autopsy showed widespread infection with Strongyloides stercoralis, with parasites in the digestive tract, lungs, and spleen. Changes were also noted in the brain. This case represents the first death attributable to infection by S. stercoralis. Its outcome illustrates the importance of early diagnosis and treatment of Strongyloides stercoralis infection in patients with impaired immune function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Development and progression, Strongyloidiasis, Strongyloides stercoralis

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