Fungus ball in HIV-infected patients

Guazzelli, Luciana Silva; Unis, Gisela; Xavier, Melissa Orzechowski; Severo, Cecília Bittencourt; Picon, Pedro Dornelles; Severo, Luiz Carlos

doi:10.1590/s0036-46652009000600007

Cited by 6 publications

(1 citation statement)

References 24 publications

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“…In the latter case, the lesions are miliary, bilateral, involving the pleura. Disseminated multi-organ disease, a result of vascular invasion, is uncommon but highly lethal [1,13,30].…”

Section: Introductionmentioning

confidence: 99%

Multiform spectrum of pulmonary disease in lethal HIV infection cases in Latvia (2012–2016)

Kleina

Fjodorova

Dabužinskienė

et al. 2017

PoA

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In 2016, the proportion of HIV-infected persons in the Baltic countries was as follows: Latvia 18.5, Estonia 17.4, Lithuania 7.4 per 100,000 of population. The aim of our study was to evaluate the spectrum and morphology of combined lung pathologies in fatal HIV/AIDS cases in Latvia from 2010 to 2016. We did a retrospective review of the HIV/AIDS patients' medical autopsy case files and histological slides at the Pathology Centre of Riga Eastern Clinical University Hospital. All statistical data were processed in IBM SPSS Statistics 23. We analysed 455 cases -311 (69%) men, 134 (31%) women. The mean age of the analysed patients was 40 years (±9 SD, range 22-68). The conditions leading to death were opportunistic infections (OI) -28%, tuberculosis (TB) -23%, wasting syndrome complicated by nonspecific pneumonia and sepsis or HIV/AIDS unrelated conditions -27%, malignancies -11% (B large cell lymphoma, primary and secondary cancers of the lung, Kaposi sarcoma), and end stage liver disease -11%. Lungs were affected in 380 cases (83.5%). We identified 112 cases of tuberculosis (TB). In 21%, it was isolated pulmonary TB, in 79% -disseminated TB. Additionally, OI were proved in 26% of these patients. The prevalence of OI was higher in patients who died from isolated pulmonary TB. We also identified 10 cases of disseminated atypical mycobacteriosis. Opportunistic infections were diagnosed in 126 persons -77% (n=97) of them had one, but 23% (n=29) had two or more OIs. The most common isolated OI with lung involvement was https://doi.org/10.12697/poa.2017.26.2.06Papers on Anthropology XXVI/2, 2017, pp. 53-67 54 | R. Kleina, O. Fjodorova, A. Dabužinskienė, J. Nazarovs, O. Mahmajeva Pneumocystis jiroveci (PC) pneumonia (n=71, 15.6%); 10% had cryptococcosis, 1% -pulmonary aspergillosis and Candida pneumonia each. 40 patients (9%) had disseminated cytomegalovirus (CMV). Among the various combinations of oppor tunistic infections, the most common was PC+CMV. 81% of HIV patients were unemployed and prisoners with interrupted treatment. We concluded that our study revealed that combined opportunistic infections and TB were the most frequently observed pulmonary infections, followed by primary and secondary lung malignancies and bacterial pneumonia in HIV/ AIDS unrelated cases of multiorgan disease. Diagnostic difficulties occurred mainly in disseminated diseases due to nonspecific clinical presentation, similar appearance on imaging studies and limited bacterial diagnostic possibilities after death.

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“…In the latter case, the lesions are miliary, bilateral, involving the pleura. Disseminated multi-organ disease, a result of vascular invasion, is uncommon but highly lethal [1,13,30].…”

Section: Introductionmentioning

confidence: 99%

Multiform spectrum of pulmonary disease in lethal HIV infection cases in Latvia (2012–2016)

Kleina

Fjodorova

Dabužinskienė

et al. 2017

PoA

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State of the art diagnostic of mold diseases: a practical guide for clinicians

Beirão

Araújo

2012

Eur J Clin Microbiol Infect Dis

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The epidemiology of fungal diseases changed, and molds have been increasingly associated with high mortality in severe immunocompromised patients. Invasive mold diseases may originate from the airborne conidia through inhalation or inoculation in skin fissures associated with indwelling catheters, wounds, burns, or onychomycosis. The diagnosis and treatment of fungal diseases is problematic and raises considerable challenges. Diagnosis of invasive mold diseases includes several methodologies, of which the most commonly used are the cultural methods, antigen testing, nucleic acid detection, and radiological imaging. Galactomannan and (1 → 3)-β-D-glucan detection significantly improved mold diagnosis in the last decade. Several molecular strategies have been proposed over the years but no consensus was achieved for standardized protocols or cut-off values. Recently, the first commercially available molecular assay for detection of Aspergillus was tested and the results were highly reproducible. In addition, blood cultures may also be helpful for invasive aspergillosis by following a novel procedure for the recovery of Aspergillus spp. from blood cultures. The association of distinct diagnostic methods, particularly molecular tests, galactomannan, and/or (1 → 3)-β-D-glucan detection, may provide earlier and more sensitive diagnosis of mold diseases and be indicative for early antifungal treatment. Accurate routine use of diagnostic tests can be cost-effective for laboratories and be of great value to patients.

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