Opportunistic fungal infections in patients with HIV disease

Abstract

Preview The increasing number of patients surviving with advanced HIV infection presents new challenges to physicians who care for them. As a patient's CD4+ T-lymphocyte count declines, susceptibility to opportunistic fungal infections increases. In this article, Dr Kirchner discusses two commonly encountered pathogens, Cryptococcus neoformans and Histoplasma capsulatum.

Disseminated cryptococcosis and histoplasmosis co-infection in a HIV-infected woman in France

“…capsulatum is a dimorphic fungus which is endemic in many regions of America and in Latin America. 1,2 The incidence of disseminated histoplasmosis in U.S.A. is about 5% in AIDS patients within endemic areas and can reach 25% during outbreaks in hyperendemic areas. 2 Disseminated histoplasmosis is diagnosed more frequently in sub-Saharian Africa since AIDS era.…”

“…1,2 The incidence of disseminated histoplasmosis in U.S.A. is about 5% in AIDS patients within endemic areas and can reach 25% during outbreaks in hyperendemic areas. 2 Disseminated histoplasmosis is diagnosed more frequently in sub-Saharian Africa since AIDS era. 4 Many African HIV-infected patients living in Europe are at some risk of histoplasmosis.…”

“…capsulatum infection has emerged as an important complication of AIDS and is the most common systemic mycosis among HIV-infected patients in histoplasma-endemic areas. 1,2 We report a case of disseminated cryptococcosis and histoplasmosis co-infection involving an African HIV-infected woman in France.…”

Computed tomography of the thorax in HIV disease

“…Since the radiological appearances are non-specific, the diagnosis requires isolation of the organism from the lungs or elsewhere. Sputum analysis has been found to be unreliable and examination of bronchial aspirates is often necessary for diagnosis [38]. In keeping with other causes of opportunistic infections, CT is particularly useful in the patient who has symptoms but in whom the chest radiograph is normal.…”

Unusual Pathogens in Hiv Positive Cases

“…However, cases are reported almost exclusively in patients who live in or have travelled to endemic areas (Central America and Central North America) and only rarely in patients from non-endemic areas [4][5][6][7]. It is still, however, a relatively uncommon pathogen in AIDS patients, even in endemic areas [8][9][10][11]. Diagnosis is often elusive and treatment difficult [12].…”