Listeriosis in patients with HIV infection: clinical manifestations and response to therapy

Article Abstract:

Listeria monocytogenes, a bacteria which causes listeriosis, can infect patients with impaired cellular immunity. Listeriosis is characterized by failure of the cardiovascular system, shock, endocarditis (inflammation of the lining of the heart chambers), swelling of the liver and spleen, and a dark red rash over the trunk of the body and the legs. Although cellular immunity is impaired in patients with AIDS, listeriosis is not common. An increase in the number of cases of listeriosis has been seen in New York City hospitals. The medical records of 30 patients with listeriosis from three medical centers in New York City over an eight-year period, from 1981 to 1988, were reviewed. Of the 30 patients with listeriosis, there were 11 patients with AIDS or risk factors for the development of AIDS. Of the 11, six had AIDS, one was infected with the virus but did not have any symptoms, and four had risk factors for the disease, such as homosexuality or intravenous drug use. In patients without AIDS and without risk factors for AIDS, the same number of cases of listeriosis occurred each year. But in the later years of the survey, between 1985 and 1988, nine out of the 11 patients with AIDS or AIDS-risk factors were identified. The clinical manifestations of listeriosis in the patients with AIDS or with risk factors for AIDS included bacteria in the blood, meningitis (inflammation of the membranes surrounding the brain and spinal cord), and endocarditis. These symptoms were similar to those in patients with listeriosis who did not have risk factors for AIDS. Antibiotic treatment for listeriosis was successful and there were no relapses. Therefore, although Listeria monocytogenes does not commonly cause infection in patients with HIV infection, an increasing number of cases is being seen because of the increasing number of AIDS patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Meningitis, Bacteremia, Listeria monocytogenes, Listeriosis

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Cryptococcus neoformans pulmonary infection in HIV-1-infected patients

Article Abstract:

The yeast-like fungus Cryptococcus neoformans (Cn) is a common infecting agent in patients with human immunodeficiency virus (HIV-1) infection. The clinical signs, symptoms, and course of 18 HIV-1-infected patients with Cn lung infection were assessed. Cn was detected in the cerebrospinal fluid, which surrounds the brain and spinal cord, of 10 of 16 patients examined. At the time of diagnosis, fever was present in 87 percent of patients and lung disorders in 60 percent of cases. Chest X-ray findings included the presence of widespread accumulation of substances between the cells in both lungs, the formation of nodules or cell aggregations, and lesions within the lung cavities. Nine of 18 patients died within six weeks after diagnosis. Five of six patients with an isolated Cn infection of the lung died. Out of these five patients, three were not receiving maintenance therapy or continuous treatment, and had a recurrence of infection. Cn infection of the lung may spread to other body sites, and it is recommended that patients receive both initial and maintenance treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Lungs, Lung, Cryptococcal infections, Cryptococcosis

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Self-reported sleep quality in HIV infection: correlation to the stage of infection and zidovudine therapy

Article Abstract:

Sleep is often disrupted in individuals infected with the human immunodeficiency virus (HIV), possibly because of psychiatric conditions such as anxiety and depression, opportunistic infections and cancer, or other symptoms of HIV infection, such as diarrhea or fever. Treatment with zidovudine has also been reported to cause disruption in sleep. The quality of sleep in 50 patients who were infected with HIV was investigated by questionnaires filled out by the patients. The patients were in different stages of disease and some were being treated with zidovudine (AZT). Analysis showed that sleep disturbance was correlated to the stage of disease and was more significantly disrupted in the later, more severe stages of AIDS. The level of depression among the patients did not generally differ significantly with the various stages. Thus, sleep disturbance did not correlate with depression. AZT treatment was not found to affect sleep significantly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Sleep, Zidovudine

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