Salmonella is Gram-negative bacilli that cause a foodborne infections. When the disease occurs in patients living with HIV (PLWHA), salmonellosis is an AIDS defining illness. Here we describe the case of a 26-year-old HIV-infected female patient who was hospitalized for pain in the right upper quadrant of the abdomen, and whose explorations revealed a liver abscess due to salmonella enterica enterica that progressed well after needle aspiration and antibiotic treatment.
Visceral leishmaniasis in HIV-infected patients is marked by a high mortality rate and its frequent relapses. It is characterized by the involvement of organs that are not usually affected in non-immunocompromised patients. We report a case of relapsing visceral leishmaniasis in an HIV-infected patient. HIV infection was discovered simultaneously as the first episode of visceral leishmaniasis. Even after recovery of visceral leishmaniasis and effective antiretroviral treatment with a negative viral load during three years, the TCD4 count remained low, contributing to visceral leishmaniasis relapse. The clinical presentation of the relapse was more severe and atypical, with renal and respiratory involvement leading to his death. Through this case and a literature review, we will discuss the relation between TCD4 count and visceral leishmaniasis in this coinfection.
Introduction: Opportunistic intestinal parasites (OIP) are a major cause of diarrhea in patients with HIV infection. We carried out this study to assess the prevalence and characteristics of OIP in Marrakech. Method: A retrospective cross-sectional study in a hospital environment was carried out in the infectious diseases department of Mohammed VI University Hospital, from January 2007 to October 2019. The diagnosis of OIP was made by parasitological examination of the stool, gastro panel intestinal FilmArray® multiplex PCR and / or histology. Result: Forty-eight patients with IOP were included. The prevalence of IOP was 5.17%, 40 patients had cryptosporidiosis, 6 patients had microsporidiosis and 2 patients had isosporosis. Thirty patients had co-infection with other opportunistic infections. Thirty-five patients were on ARVs. Eleven patients (22.9%) died during the study and 77.1% did well. Conclusion: The results of our study should prompt physicians treating HIV-infected patients in Morocco to request a stool exam and specific tests for Cryptosporidium, microsporidia and Isospora, especially in patients with low CD4 count.
Background Tuberculosis is a health problem in Morocco, which is increasingly indicative of human immunodeficiency virus (HIV) infection. Objective To determine the epidemiological, clinical and paraclinical, therapeutic and evolutionary aspects of tuberculosis and HIV co-infection. Methods we report 135 cases co-infected with HIV and tuberculosis, collected by the infectious diseases department at the Mohammed VI University Hospital in Marrakech. This is a 12-year retrospective study (2007 to 2020) that involved all HIV-infected patients hospitalized for tuberculosis regardless of its location. Results The mean age of the patients was 40 years (17-73 years). A male predominance was noted in 69% of cases. In 74.6% of cases, tuberculosis was indicative of HIV infection. Nine patients were receiving antiretroviral (ARV) treatment at the time of the discovery of tuberculosis. There were 24% pulmonary tuberculosis, 25.3% extrapulmonary tuberculosis and 49% disseminated tuberculosis. Tuberculosis was confirmed in 31.7% of cases. At the time of tuberculosis diagnosis, the average CD4 count was 86 cells / mm. Quadruple therapy with isoniazid, rifampicin, pyrazinamide and ethambutol was started in 83% of patients. The average time to start ARVs was 7 weeks. All patients who received ARVs received a combination therapy comprising the combination of 2 nucleoside analogs and one non-nucleoside analog. At the end of our work, the evolution was favorable in 53% of cases, death occurred in 25% of cases, 18.6% of patients were lost to follow-up, two cases of failure and another of relapse. Immune restoration syndrome was noted in 8 cases. Drug toxicity was observed in 24.5% of patients, 73% of which was related to hepato-toxicity of antibacillary drugs. Conclusion Tuberculosis is the most common opportunistic infection in people with HIV. Despite the advent of highly active triple therapy, tuberculosis is still a major cause of death in HIV positive people. Disclosures All Authors: No reported disclosures
Gastric cancer remains one of the most common and deadly cancers worldwide, especially among old males. It is rare in the younger population (< 30 years old). We describe the case of a 27 years old male patient, presenting to the emergency department, with exsudative polyserositis, initially misdiagnosed and treated as a multifocal tuberculosis with no clinical improvement, later revealing a metastatic signet ring cells gastric adenocarcinoma.
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