Resolution of Kaposi's sarcoma

Clinical and Microbiological Survey of Serratia marcescens Infection During HIV Disease

“…On the other hand, like others who reported previous experience with HIV-infected patients [9,10,14,[25][26][27][28][29][30], we did not observe any episodes of urinary tract infection. Nearly 50% of episodes in our series were polymicrobial in origin (others were described in 3 previous reports) [9,10,25], making the assessment of the pathogenetic potential of Serratia spp.…”

“…While early studies reported an increased incidence of encapsulated bacteria and staphylococci as leading AIDS-related bacterial pathogens [7,9], recent surveys stressed a progressive upward trend of gramnegative bacilli as important agents of HIV-associated bacterial complications [7,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. However, to our knowledge only 13 episodes of Serratia marcescens infection have been described in HIV-infected patients since 1987, in nine different reports [9,10,14,[25][26][27][28][29][30]: seven cases of pneumonia [10,25,30], three cases of septicaemia [9,14,28], and one case each of endophthalmitia [27], perifolliculitis [29], and bacteraemic cholecystitis [26]; no cases of urinary tract disease or infection due to non-marcescens Serratia spp. were reported.…”

“…were reported. Unfortunately, these episodes have been reported as a part of large series dealing with bacterial complications of HIV disease (with most clinical and therapeutic details lacking) [9,10,14,25,30] or as anecdotal single-case observations [26][27][28][29].…”

“…In 1994 Burack et al [10] reported three cases of community-acquired pneumonia caused by Serratia marcescens in a series of 162 episodes; all bacterial isolates were resistant to cefuroxime but susceptible to ceftazidime and cotrimoxazole, and in two cases three other pathogens were present concomitantly [10]. In 1994 O'Connell [28] reported a case of recurrent Serratia marcescens sepsis favourably treated with ceftazidime and possibly related to the surprising resolution of concomitant Kaposi's sarcoma in a homosexual male with an extremely low CD4c cell count and multiple AIDS-related disorders. Three more cases of Serratia marscescens pneumonia were described in 1995 in a series of 89 cases of microbiologically confirmed pneumonia; a positive culture was obtained from sputum in two cases and from bronchoalveolar lavage fluid in the remaining case [25].…”

“…Prior reports suggested some relationship between the occurrence of Serratia spp. infection and full-blown AIDS or a low CD4c lymphocyte count [26,28] as well as prolonged hospitalization. In fact, hospital admission seems to play a promoting role through duration of hospitalization, drug administration, and diagnostic or therapeutic instrumentation, particularly the use of central i.v.…”