Fungal infections in HIV-infected patients

Abstract

Opportunistic fungal infections are commonly encountered in the acquired immunodeficiency syndrome (AIDS) patient population. Fungal infections in the patient infected with the human immunodeficiency virus (HIV) are a major cause of morbidity and mortality. The yeasts Candida and Cryptococcus neoformans, the dimorphic fungi Histoplasma capsulatum and Sporothrix schenckii, and the dermatophyte fungi are the most common pathogenic fungi in patients infected with HIV. The characteristics of these and other relevant mycotic pathogens, and their clinical presentation are discussed. Mycoses in the patient infected with HIV are often atypical, and can be masked by other infections. Cutaneous manifestations may provide valuable diagnostic clues. The clinician must maintain a high index of suspicion to establish an early diagnosis and rapidly institute therapy. Treatment may suppress rather than cure the mycosis, because host immunity in conjunction with antifungal agents is necessary to eliminate infection.

Bacterial and fungal agents causing lower respiratory tract infections in patients with human immunodeficiency virus infection

“…24,25 Some of the studies from abroad state that there is a shift in distribution of Candida species from albicans to Non albicans group in HIV individuals. 26 Six cases of cryptococcal pneumonia were identified in the study, out of which 2 cases from stage-I and 4 from stage-IV. All the four cases of stage-IV were hospitalized and two expired.…”

Melanin as a virulence factor of Paracoccidioides brasiliensis and other dimorphic pathogenic fungi: a minireview

“…The mycelial phase predominates in the environment whereas yeast-like forms develop in infected human and animal tissues [60]. Most cases of sporotrichosis are localized to the skin and subcutaneous tissues, although dissemination to osteoarticular structures and viscera may occur in both healthy and immunosuppressed individuals, particularly individuals with AIDS [61]. In vivo-cfu g/tissue g 30,000 ± 400 19,000 ± 800 [44] In vitro resistance to oxidants Existing data suggests that the conidia of S. schenckii produce melanin compounds via a 1,8-dihydroxynaphthalene pentaketide pathway [5].…”

Adhesion of the human pathogen Sporothrix schenckii to several extracellular matrix proteins

“…This disease has several clinical forms, the most frequent being the cutaneous/subcutaneous one, with associated lymphangitis and lymph node enlargement (1). Systemic spread may affect the bone, central nervous system and lung, and has been associated mainly with immunocompromised individuals (1)(2)(3)(4)(5). These systemic forms of the disease can follow a pulmonary infection by conidia inhalation (6) or dissemination from a cutaneous/subcutaneous lesion (2).…”

“…Recently, spo-rotrichosis has been reported to be an important mycosis in HIV + individuals (5). In these patients, osteoarthritis and the disseminated form of sporotrichosis are frequently observed (3,4).…”