No abstract

Five cases of large tuberculous abscesses in patients with AIDS were observed over a 2-year period at the New York Veterans Affairs Medical Center. These cases represent 11.6% of the 43 cases of tuberculosis diagnosed in patients with AIDS during that period. The abscesses were located in the liver, abdominal wall, psoas muscle, mediastinum, and peripancreatic area. All patients presented with localized pain or swelling, and four of five patients had fever. The diagnosis was made on the basis of detection of abscesses on computed tomography (CT) and the results of culture of abscess material obtained by CT-guided aspiration. CT-guided therapeutic drainage was performed in two cases. Despite administration of therapy, two of five patients died of tuberculous infection. Formation of tuberculous abscesses appears to be a common complication of tuberculosis in patients with AIDS. This diagnosis should be considered for patients with AIDS who have fever and localized pain or swelling.

This study reveals infection with a broad variety of HIV-1 group M subtypes mostly in the immigrant population of New York City as well as how several non-B subtypes are being introduced into the United States.

Influenza viruses are RNA viruses that are a major determinant of morbidity and mortality caused by respiratory disease. Influenza is highly contagious and has caused epidemics and pandemics for centuries. Most influenza infections are self- limited, but lower respiratory tract and cardiac complications can result in increases in hospitalizations and deaths. The recommended composition of influenza vaccine is updated annually in order to provide a vaccine that is antigenically well matched with the new influenza virus strains that are expected to cause epidemics. Influenza vaccination significantly reduces mortality; however, approximately one third of elderly Americans are not immunized annually. The nation's goal is to increase the influenza vaccination rate among the elderly to 90%. Vaccination is the most effective measure for reducing the impact of influenza and is a cost-effective preventive health intervention for the elderly and individuals with chronic obstructive pulmonary disease.