Neutropenia, Neutrophil Dysfunction, and Bacterial Infection in Patients with Human Immunodeficiency Virus Disease: The Role of Granulocyte Colony-Stimulating Factor

Kuritzkes, Daniel R.

doi:10.1086/313642

Cited by 99 publications

(67 citation statements)

References 66 publications

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“…In addition, HIV-associated neutropenia and monocytopenia, as well as dysfunction of several of the protective activities of these cells, including chemotaxis to bacterial proteins, as well as antimicrobial activity, are potential contributors to predisposition to pneumococcal disease [40,41].…”

Section: Pneumococcal Pneumoniamentioning

confidence: 99%

HIV-Associated Bacterial Pneumonia

Feldman¹,

Anderson²

2013

Clinics in Chest Medicine

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Section: Pneumococcal Pneumoniamentioning

confidence: 99%

HIV-Associated Bacterial Pneumonia

Feldman¹,

Anderson²

2013

Clinics in Chest Medicine

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“…In fact, it can be suggested that enhancing levels of LT biosynthesis may indirectly contribute to the immunostimulation resulting from administering cytokines such as CSFs (Ref. 96 and see above). Alternatively, tissue levels of LTs at a site of infection might be amplified by their direct administration.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Leukotrienes: Underappreciated Mediators of Innate Immune Responses

Peters‐Golden¹,

Canetti²,

Mancuso

et al. 2005

The Journal of Immunology

279

244

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Leukotrienes are bronchoconstrictor and vasoactive lipid mediators that are targets in the treatment of asthma. Although they are increasingly recognized to exert broad proinflammatory effects, their role in innate immune responses is less well appreciated. These molecules are indeed synthesized by resident and recruited leukocytes during infection. Acting via cell surface G protein-coupled receptors and subsequent intracellular signaling events, they enhance leukocyte accumulation, phagocyte capacity for microbial ingestion and killing, and generation of other proinflammatory mediators. Interestingly, a variety of acquired states of immunodeficiency, such as HIV infection and malnutrition, are characterized by a relative deficiency of leukotriene synthesis. The data reviewed herein point to leukotrienes as underappreciated yet highly relevant mediators of innate immunity.

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“…Elevated neutrophil counts were previously reported in a 33-year-old woman with AIDS who had disseminated aspergillosis affecting the brain and spine (Martinez et al, 2009). Furthermore, HIV-infected patients have defects in neutrophil function as well as activation of neutrophils, contributing to this dysfunction, which may manifest at all stages of HIV disease (Kuritzkes, 2000).…”

Section: Discussionmentioning

confidence: 86%

A rare, fatal case of invasive spinal aspergillosis in an antiretroviral-naïve, HIV-infected man with pre-existing lung colonization

Rossouw

Goedhals

Merwe

et al. 2011

Journal of Medical Microbiology

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Infection of the central nervous system (CNS) is a rare but devastating complication of invasive aspergillosis. We report a case of invasive aspergillosis with spinal involvement in a human immunodeficiency virus (HIV)-infected patient without neutropenia. A 42-year-old, antiretroviralnaïve, HIV-infected man presented with progressive weakness in the lower limbs and urinary and faecal incontinence for 2 weeks. The patient had been prescribed broad-spectrum antibiotics and prednisone. He had upper motor neuron signs and a sensory level at T1, with accompanying neck stiffness on flexion. Magnetic resonance imaging revealed diffuse abnormal signals of the vertebral bodies in the lower cervical and thoracic areas, with cord compression in the C2 and C3 region and signal distortions of the T2 and T3 vertebral bodies. Chest X-ray and computerized tomography demonstrated post-tuberculous apical cavities with suspected fungal colonization. Histopathology of an extradural spinal lesion at T1/T2 suggested invasive aspergillosis. The patient was started on fluconazole in response to the histopathological evidence of Aspergillus infection, but died within 3 weeks. Post-mortem analysis of the biopsy sample by PCR identified the infectious agent as Aspergillus fumigatus. Atypically, his CD4 + T-cell count was 239 cells mm "3 and he had no evidence of neutropenia. Invasive aspergillosis should be considered as part of the differential diagnosis among HIV-infected patients with non-specific, focal CNS symptoms, even among those without classical risk factors such as neutropenia, and aggressive antifungal therapy should be instituted as early as possible. IntroductionAspergillus species are the most frequently isolated moulds among human immunodeficiency virus (HIV)-infected patients (Enoch et al., 2006), but invasive aspergillosis is very uncommon in this population (,1 %) (Cornet et al., 2002). Despite this low incidence, it is of particular importance because the case-fatality rate associated with disseminated infection or central nervous system (CNS) involvement is reported to be 88 % (Lin et al., 2001). Among HIV-infected persons, invasive aspergillosis usually occurs in patients with a CD4 + T-cell count of ,50 cells mm 23 and in those with neutropenia or on corticosteroids (Mylonakis et al., 1998). However, CNS aspergillosis has also been described in immunocompetent patients and following epidural steroid injections (Haran & Chandy, 1993; Larson Kolbe et al., 2007;Saigal et al., 2004;Sundaram et al., 2006). Aspergillosis generally affects the lungs, but can also spread to other organs, including the CNS. Based on a large, randomized-controlled trial, the drug of choice for invasive aspergillosis is voriconazole (Herbrecht et al., 2002). However, a diagnosis of invasive aspergillosis is often only made post-mortem, and a definitive diagnosis requires both microscopic analysis of tissue and identification of the organism by culture (Walsh et al., 2008).Aspergillus infection in the CNS is rare, but appears to be becoming mo...

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Neutropenia, Neutrophil Dysfunction, and Bacterial Infection in Patients with Human Immunodeficiency Virus Disease: The Role of Granulocyte Colony-Stimulating Factor

Cited by 99 publications

References 66 publications

HIV-Associated Bacterial Pneumonia

HIV-Associated Bacterial Pneumonia

Leukotrienes: Underappreciated Mediators of Innate Immune Responses

A rare, fatal case of invasive spinal aspergillosis in an antiretroviral-naïve, HIV-infected man with pre-existing lung colonization

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