Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
INTRODUCTION: Infectious endocarditis (IE) in injecting drug patients with human immunodeficiency virus (HIV) is manifested predominantly by damage to the tricuspid valve (TV). The pathogen of the disease is Staphylococcus aureus. The IE peculiarities of the TV in this category of patients are multiple septic emboli in the small circulation, which may result from flotation vegetations, and predominance of pulmonary symptomatology over cardiac phenomena. CASE PRESENTATION: A 30-year-old female HIV-infected injecting drug user was dynamically monitored for the laboratory-confirmed IE development by transthoracic echocardiography during a year. The patient was twice admitted to the intensive care unit in a serious condition with purulent-septic complications in the lungs in the form of bilateral polysegmental destructive (septic) pneumonia confirmed by X-ray and multispiral computed tomography. After intensive therapy, the patient refused further ARV treatment and consultations with a cardiac surgeon. A clinical follow-up demonstrated IE of the TV and right-sided lower lobe pneumonia in an HIV-infected drug-dependent patient after a cesarean section. Immunodeficiency without appropriate ARV therapy had a negative impact on the course of the disease. According to transthoracic echocardiography, an increase in TV vegetations from 7 mm to 16 mm and regurgitation were observed, whereas left ventricular ejection fraction decreased from 60% to 47% during the follow-up. Complications of cesarean section, immunodeficiency, and absence of ARV therapy could be the trigger factors of the IE development. Injection drug use with possible violations of asepsis and circulation of microorganisms of the causative agents in the blood contributed to the rapid development of the disease and was a determining factor of the infectious process in the TV. CONCLUSIONS: Echocardiography remains the primary radiological diagnostic method for examining HIV-infected drug-dependent patients with fever and/or after medical manipulations. However, this group of patients more frequently clinically manifests the disease with bright pulmonary pathology. Therefore, radiological methods should necessarily be a priority during the diagnostic search. The sources of septic embolism in the small circulation in IE may be loose and floating TV vegetations.
INTRODUCTION: Infectious endocarditis (IE) in injecting drug patients with human immunodeficiency virus (HIV) is manifested predominantly by damage to the tricuspid valve (TV). The pathogen of the disease is Staphylococcus aureus. The IE peculiarities of the TV in this category of patients are multiple septic emboli in the small circulation, which may result from flotation vegetations, and predominance of pulmonary symptomatology over cardiac phenomena. CASE PRESENTATION: A 30-year-old female HIV-infected injecting drug user was dynamically monitored for the laboratory-confirmed IE development by transthoracic echocardiography during a year. The patient was twice admitted to the intensive care unit in a serious condition with purulent-septic complications in the lungs in the form of bilateral polysegmental destructive (septic) pneumonia confirmed by X-ray and multispiral computed tomography. After intensive therapy, the patient refused further ARV treatment and consultations with a cardiac surgeon. A clinical follow-up demonstrated IE of the TV and right-sided lower lobe pneumonia in an HIV-infected drug-dependent patient after a cesarean section. Immunodeficiency without appropriate ARV therapy had a negative impact on the course of the disease. According to transthoracic echocardiography, an increase in TV vegetations from 7 mm to 16 mm and regurgitation were observed, whereas left ventricular ejection fraction decreased from 60% to 47% during the follow-up. Complications of cesarean section, immunodeficiency, and absence of ARV therapy could be the trigger factors of the IE development. Injection drug use with possible violations of asepsis and circulation of microorganisms of the causative agents in the blood contributed to the rapid development of the disease and was a determining factor of the infectious process in the TV. CONCLUSIONS: Echocardiography remains the primary radiological diagnostic method for examining HIV-infected drug-dependent patients with fever and/or after medical manipulations. However, this group of patients more frequently clinically manifests the disease with bright pulmonary pathology. Therefore, radiological methods should necessarily be a priority during the diagnostic search. The sources of septic embolism in the small circulation in IE may be loose and floating TV vegetations.
Background. The clinical course of COVID-19 infection can be significantly affected by severe immunosuppression, viral load, concomitant diseases and conditions not related to HIV, the absence of antiretroviral therapy. It is potentially important to assess the state of post-ovoid immunity for the provision of medical care to HIV-infected patients with COVID-19. Aim: to assess the impact of HIV infection on the clinical course of a new coronavirus infection, the severity of the disease and its outcomes, and immune response. Materials and methods. Medical records of 35,328 patients who underwent COVID-19 in 2020 were analyzed, including 46 cases of SARS-CoV-2 infection in HIV-infected individuals. To determine specific antibodies to SARS-CoV-2, 281 blood samples were examined by ELISA. The clinical course of COVID-19 in HIV-infected patients, as well as the production of IgG to SARS-CoV-2, depending on the level of CD4 and viral load, were assessed. Results. In 76% of co-infected patients, there were signs of progression of HIV infection, opportunistic infections and concomitant diseases. 52.2% of the analyzed group were users of psychoactive substances. Among patients co-infected with HIV and COVID-19, men predominated in the age groups over 30 years old, while among the HIV-negative population, women in the age groups over 18 years old predominated. The proportion of severe forms of COVID-19 in HIV-infected people (47.8%) exceeds that in the group of patients without immunodeficiency (12.3%). The mortality rate from COVID-19 among HIV-infected people was more than 7 times higher than that of the HIV-negative population of the region (t=1.81; p=0.01). Among the examined 72 HIV-infected patients, IgG antibodies to SARS-CoV-2 were detected in 20 patients, of which 4 (28.5%) with confirmed HIV/SARS-CoV-2 co-infection and 16 people (27.5%) without medical confirmation. HIV-infected patients with severe immunodeficiency did not develop a humoral immune response to COVID-19 infection, and in 25% the immune response lasted less than 3 months. Conclusions. HIV-infected patients are at greater risk of developing a severe course of coronavirus infection. The presence of deep immunodeficiency and high viral load in patients without antiretroviral therapy significantly reduces tension and shortens the development and duration of post-COVID immunity.
Aim. To form for viewers an actual vision of the issue of septic pulmonary embolism in the terminological, morphological and clinical aspects, as well as presentation of the methodic of medical imaging of such patients, to systematize and illustrate the main and rare CT signs of septic embolism.Materials and methods. We analyze the data of national and foreign scientific papers for 2001-2021 on the platforms PubMed, Elibrary, etc., as well as earlier "classic" publications on sepsis, infectious endocarditis and septic pulmonary embolism. Also presents own experience of practice with such patients in multidisciplinary hospitals and typical cases, taking into account more than 5 years of experience on this topic in radiology departments in cooperation with related specialists (cardiologists, therapists, purulent surgeons, morphologists).Results. 52 of the most relevant scientific papers were selected from 162 available articles. Based on the results, a review was compiled on the peculiarities of terminology, epidemiology, etiology, clinical presentations, as well as methods for diagnosis of septic pulmonary embolism, CT signs of verified cases during primary scanning, as well as follow-up images, which is extremely important in differential diagnosis. The part with the pathological anatomy of septic embolism makes it possible to better understand CT signs and the difference between this process from ordinary pneumonia.Conclusion. Due to the fact that septic embolism is a secondary process, the correct and quick interpretation of the CT images initiates the search for the primary purulent source of embolism in the body, and follow-up CT-scans (especially in infectious endocarditis) allows you to assess the effectiveness of therapy.
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.