Letters to the Editor CD4 lymphocyte count which was 277/mm3 at the time of diagnosis. He was evaluated by two ophthalmologists, both of whom confirmed CMV retinitis with a retinal detachment. In addition he had a vitreal biopsy which was positive by PCR for CMV and negative for herpes simplex, herpes zoster and Toxoplasma gondii. His retinitis failed to respond to intravenous genciclovir, but subsequently responded to induction with 3 weeks of intravenous foscamet therapy and remains quiescent on IV foscamet maintenance therapy. Following diagnosis of CMV infection his CD4 count fell to 90/mm3 within 6 months, although it improved with combination antiretroviral therapy (zidovudine and zalcitabine HIV itself alone, in the absence of other infecting agents, also has been implicated as a cause of prostatic abnormalities.2In the current literature we rarely find reports of prostatitis caused by cytomegalovirus (CMV) in HIV-positive persons. ' We here report a rare case of prostatitis due to CMV infection in a patient with AIDS in whom the diagnosis was established after death and who received antiviral chemotherapy with ganciclovir.A 34 year old intravenous drug abuser with AIDS was hospitalised complaining of lower abdominal pain, urinary frequency without dysuria, and fever. Six months before he had came to our attention because of CMV retinitis that had been treated with ganciclovir with a successful response, but the patient had not continued with a maintenance therapy. At the moment of the admission he appeared severely ill. The laboratory studies revealed a CD4 + lymphocyte cells count below 50/pl, a white blood cells count (WBC) of 3400/mm3 with 60% neutrophils, and 18% lymphocytes, an erythrocyte sedimentation (ESR) rate of 78 mm/hour, and a lactate dehydrogenase (LDH) value of 650 U/l. Urinanalysis revealed one to five WBC per high power field without casts and trace amounts of protein. Repeated urine culture grew CMV. Microscopic and cultural examinations of blood, sputum and stool specimens were unremarkable. An ultrasound evaluation of the lower abdomen was normal. The examination of the prostate was normal. An active CMV retinitis in the right ocular fundus was detected. Reinduction therapy with ganciclovir was started in association with cotrimoxazole. The patient's clinical condition continued to deteriorate, and he died after two weeks of hospitalisation. Post mortem examination reported a disseminated CMV infection, with prominent localisation in the prostatic gland, the lungs and the adrenal glands. Macroscopic evaluation revealed a normal sized prostate, while microscopically there was evidence of a large inflamed prostatic epythelium with multiple areas of tissue necrosis containing CMV intranuclear and intracytoplasmatic inclusions.Although infection with CMV is commonly benign in the immunocompetent person, the virus remains a major cause of morbidity and 447 on 1 May 2019 by guest. Protected by copyright.
Chlamydia pneumoniae, strain TWAR, is a frequent causative agent of acute respiratory disease. We assessed the incidence and prevalence of Chlamydia pneumoniae infections in COPD. We studied, from January 1990 to May 1991, 142 out-patients with acute purulent exacerbations of chronic obstructive pulmonary disease (COPD) and 114 healthy control subjects. Oropharyngeal swab specimens were collected at each exacerbation and analysed using a high definition monoclonal indirect fluorescent antibody test for Chlamydia pneumoniae identification. Immunoglobulins G and M (IgG and IgM) fractions of antibodies to Chlamydia pneumoniae were studied by microimmunofluorescence test. Prevalence of specific IgG was 63% in COPD, and 46% in controls (Chi-squared test p = 0.007). Moreover, mean titre of IgG was significantly higher in COPD than in controls. Five patients were positive for specific IgM (> or = = 1:16), and one had a fourfold increase of IgG titre; four of these patients had been treated with ciprofloxacin 1 g.day-1 for 10 days, and two with erythromycin, 3 g.day-1 for 14 days, with remission of signs and symptoms of exacerbation. Chlamydia pneumoniae identification was always negative. Our data suggest that Chlamydia pneumoniae infection is a rather frequent event in COPD, since at least 4% of exacerbations may be associated with it.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.