Displaying publications 1 - 20 of 94 in total

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  1. Nissapatorn V
    PMID: 20578449
    Toxoplasmosis has historically been considered one of the most important opportunistic infections detected in HIV/AIDS patients. The prevalence rates of latent Toxoplasma infections in HIV-infected patients has been found to vary greatly from 3% to 97%. Prevalence has been found to be related to ethnicity, certain risk factors, and reactivation of toxoplasmosis. Prior to antiretroviral therapy, toxoplasmic encephalitis (TE) was the most common focal cerebral lesion detected in AIDS patients with Toxoplasma infection, occurring in approximately half of Toxoplasma-seropositive patients. Other forms of dissemination have also been reported in AIDS patients in sites such as the eyes, lungs, heart and spinal cord. Anti-Toxoplasma therapy and chemoprophylaxis have shown effectiveness in reducing the incidence of TE, while noncompliance has been identified as a cause of relapse in these settings. Toxoplasmosis is one of the most common neuropathological complications found at autopsy. Rapid progress in the development of highly active antiretroviral therapy (HAART) has changed the observed patterns with TE, for which there has been a marked decrease in overall incidence. Subsequently, TE has been found to be significantly associated with the so-called "neurological immune restoration inflammatory syndrome" (NIRIS). Toxoplasma screening programs are recommended for all newly diagnosed HIV-positive patients. Chemoprophylaxis should be considered in HIV-infected patients who have a CD4 < 200 cells/mm3, particularly in settings where resources are limited and there is not access to HAART. TE remains a cause of morbidity and mortality among AIDS patients.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/immunology; AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/parasitology*; AIDS-Related Opportunistic Infections/prevention & control
  2. Navarro-Muñoz JC, de Jong AW, Gerrits van den Ende B, Haas PJ, Then ER, Mohd Tap R, et al.
    Mycopathologia, 2019 Dec;184(6):731-734.
    PMID: 31734799 DOI: 10.1007/s11046-019-00404-0
    Candida vulturna is a new member of the Candida haemulonii species complex that recently received much attention as it includes the emerging multidrug-resistant pathogen Candida auris. Here, we describe the high-quality genome sequence of C. vulturna type strain CBS 14366T to cover all genomes of pathogenic C. haemulonii species complex members.
    Matched MeSH terms: Opportunistic Infections/microbiology
  3. Lorenzo-Morales J, Sifaoui I, Reyes-Batlle M, Lares-Villa F, Lares-Jiménez LF, Omaña-Molina M, et al.
    Exp Parasitol, 2019 May;200:36.
    PMID: 30902622 DOI: 10.1016/j.exppara.2019.03.010
    Matched MeSH terms: Opportunistic Infections/parasitology*
  4. Arijit G, Shalini C
    Med J Malaysia, 2007 Mar;62(1):88.
    PMID: 17682586
    Nepal is a low prevalence country for HIV/AIDS but has progressed into the category of a "concentrated" epidemic. The epidemic remains concentrated in a few vulnerable populations, namely Female Sex Workers and their clients, Intravenous Drug Users and Seasonal Migrant Workers. There is a big difference between estimated and reported cases for HIV, >60000 and almost 5000 respectively1 . There might be many more undiagnosed cases. Mother–to–child transmission is the largest source of HIV infection in children in Nepal so far.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/etiology; AIDS-Related Opportunistic Infections/mortality; AIDS-Related Opportunistic Infections/epidemiology*
  5. Gan GG, Kamarulzaman A, Goh KY, Ng KP, Na SL, Soo-Hoo TS
    Med J Malaysia, 2002 Mar;57(1):118-22.
    PMID: 14569730
    We report a case of an invasive infection with non-sporulating Chrysosporium species in a patient who was treated with chemotherapy for relapsed acute lymphoblastic leukemia. This patient presented with a persistent lobar pneumonia, skin lesions, and possible involvement of the central nervous system. The patient responded to treatment with amphotericin B and oral itraconazole.
    Matched MeSH terms: Opportunistic Infections/diagnosis*
  6. Tan HJ, Cheong I, Muhaizan WM
    Med J Malaysia, 2000 Jun;55(2):259-62.
    PMID: 19839156
    Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. Although uncommon, it should be considered among the list of important opportunistic infections in severely immunocompromised patients. Patients living with AIDS are at particular risk of disseminated histoplasmosis. Diagnosis requires a high level of clinical suspicion. The infection is best confirmed by demonstration of the organism in tissue specimens or by culture. Amphotericin B is the most effective drug for severe disseminated histoplasmosis. Response is good but life-long maintenance is required to prevent relapse.
    Matched MeSH terms: AIDS-Related Opportunistic Infections*
  7. Goh KL, Chua CT, Chiew IS, Soo-Hoo TS
    Med J Malaysia, 1987 Mar;42(1):58-60.
    PMID: 3501533
    The acquired immune deficiency syndrome (AIDS) requires no further introduction. Since 1981, when the AIDS was first recognized in the United States, much interest, anxiety and fear have been generated among people all over the world. It has spread inexorably in the United States, Europe and Africa such that the World Health Organization has warned of the beginning of a worldwide epidemic of AIDS. Asia has been relatively spared; nonetheless cases have been reported from Thailand, India, Taiwan, China and Japan.' Malaysia has anticipated the appearance of the disease; an AI DS task force under the auspices of the Ministry of Health was established in early 1986. However, it is only a year later that we now report the first case of AIDS in this country.
    Matched MeSH terms: Opportunistic Infections/diagnosis
  8. Sornillo JB, Ditangco R, Kinikar A, Wati DK, Du QT, Nguyen DQ, et al.
    PLoS One, 2023;18(9):e0291523.
    PMID: 37708128 DOI: 10.1371/journal.pone.0291523
    Despite improvements in HIV testing and earlier antiretroviral therapy (ART) initiation in children living with HIV through the years, a considerable proportion start treatment with advanced disease. We studied characteristics of children and adolescents living with HIV and their level of immunodeficiency at ART initiation using data from a multi-country Asian cohort. We included children and adolescents who were ART-naïve and <18 years of age at ART initiation from 2011 to 2020 at 17 HIV clinics in six countries. Incidence rates of opportunistic infections (OIs) in the first two years of triple-drug ART (≥3 antiretrovirals) was also reported. Competing risk regression analysis was performed to identify factors associated with first occurrence of OI. In 2,027 children and adolescents (54% males), median age at ART initiation increased from 4.5 years in 2011-2013 to 6.7 in 2017-2020, median CD4 count doubled from 237 cells/μl to 466 cells/μl, and proportion of children who initiated ART as severely immunodeficient decreased from 70% to 45%. During follow-up, 275 (14%) children who received triple-drug ART as first treatment and had at least one clinic visit, developed at least one OI in the first two years of treatment (9.40 per 100 person-years). The incidence rate of any first OI declined from 12.52 to 7.58 per 100 person-years during 2011-2013 and 2017-2020. Lower hazard of OIs were found in those with age at first ART 2-14 years, current CD4 ≥200 cells/μl, and receiving ART between 2017 and 2020. The analysis demonstrated increasing number of children and adolescents starting ART with high CD4 count at ART start. The rate of first OI markedly decreased in children who started ART in more recent years. There remains a clear need for improvement in HIV control strategies in children, by promoting earlier diagnosis and timely treatment.
    Matched MeSH terms: Opportunistic Infections*
  9. Puthucheary SD, Sangkar V, Hafeez A, Karunakaran R, Raja NS, Hassan HH
    PMID: 16771229
    Rhodococcus equi, a recognized pathogen in horses, is emerging as a human opportunistic pathogen, especially in immunocompromized hosts. We describe four immunocompromized patients who had serious R. equi infections with an overall mortality of 75%. The natural habitat of R. equi is soil, particularly soil contaminated with animal manure. Necrotizing pneumonia is the commonest form of infection but extrapulmonary infections, such as wound infections and subcutaneous abscess, have also been described in humans. R. equi is cultured easily in ordinary non-selective media. Large, smooth, irregular colonies appear within 48 hours. It is a facultative, intracellular, nonmotile, non-spore forming, gram-positive coccobacillus, which is weakly acid-fast staining and bears a similarity to diphtheroids. It forms a salmon-colored pigment usually after 48 hours incubation. A particular characteristic of this organism is that it undergoes synergistic hemolysis with some bacteria on sheep blood agar. R. equi may be misidentified as diphtheroids, Mycobacterium species, or Nocardia. In vitro R. equi is usually susceptible to erythromycin, ciprofloxacin, vancomycin, aminoglycosides, rifampin, imipenem and meropenem. The organism can be difficult to eradicate, making treatment challenging. Increased awareness of the infection may help with early diagnosis and timely treatment.
    Matched MeSH terms: Opportunistic Infections/diagnosis*; Opportunistic Infections/drug therapy; Opportunistic Infections/microbiology
  10. Puthucheary SD, Ng KP, Hafeez A, Raja NS, Hassan HH
    PMID: 15691137
    Persons infected with human immunodeficiency virus (HIV) have an increased risk of salmonellosis when compared to the general population. We describe seven such patients with Salmonella bacteremia, of whom two had recurrent salmonellosis. In the latter two cases the infection was unusually severe, characterized by widespread infection, bacteremia and relapse, despite standard antimicrobial therapy. HIV-infected individuals will benefit from education on the source of Salmonella, mode of acquisition and prevention through safe food handling and food preparation practices. Because of the difficulty of eradicating Salmonella infection in patients with acquired immunodeficiency syndrome, long-term suppressive treatment with antimicrobials is warranted.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/immunology; AIDS-Related Opportunistic Infections/microbiology
  11. Kurup A, Leo YS, Tan AL, Wong SY
    Ann Acad Med Singap, 1999 Jul;28(4):605-9.
    PMID: 10561784
    Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/ethnology; AIDS-Related Opportunistic Infections/microbiology
  12. Cho J, Kandane-Rathnayake R, Louthrenoo W, Hoi A, Golder V, Chen YH, et al.
    Int J Rheum Dis, 2020 Aug;23(9):1255-1257.
    PMID: 32841510 DOI: 10.1111/1756-185X.13937
    Matched MeSH terms: Opportunistic Infections/immunology; Opportunistic Infections/epidemiology*; Opportunistic Infections/therapy
  13. Neoh CF, Snell G, Levvey B, Morrissey CO, Stewart K, Kong DC
    Int J Antimicrob Agents, 2014 Sep;44(3):194-202.
    PMID: 25123811 DOI: 10.1016/j.ijantimicag.2014.05.013
    Lung transplant (LTx) patients have an increased risk of developing invasive fungal infections (IFIs), particularly invasive aspergillosis. Rapid identification of the causative fungal pathogen, to allow for early administration of appropriate initial antifungal therapy, in LTx patients has been challenging due to the limited sensitivity and specificity of the diagnostic tools. Hence, there is increasing emphasis on antifungal prophylaxis in the LTx setting, given the high mortality rates and substantial cost of treating IFIs. Evidence for the optimal antifungal prophylactic approach in this setting, however, remains scant and inconsistent. This review will briefly discuss the epidemiology, risk factors, timing and clinical manifestations of fungal infections in LTx patients and will focus primarily on the available evidence related to the efficacy, safety and practicality of current prophylactic strategies in LTx recipients as well as challenges and gaps for future research.
    Matched MeSH terms: Opportunistic Infections/epidemiology; Opportunistic Infections/pathology; Opportunistic Infections/prevention & control*
  14. Koh KC, Pak JW
    Malays Fam Physician, 2016;11(1):27-30.
    PMID: 28461847 MyJurnal
    Immune reconstitution inflammatory syndrome (IRIS) is the paradoxical worsening of pre-existing infectious processes after commencement of anti-retroviral therapy (ART) in HIV-infected patients. Its manifestations are dependent on the underlying opportunistic infections. We report a case of an HIV-infected patient with disseminated tuberculosis, who responded to anti-tuberculosis therapy but suffered from paradoxical worsening after commencement of ART.
    Matched MeSH terms: Opportunistic Infections
  15. Lee WS, Boey CC, Goh AY
    Singapore Med J, 1999 Apr;40(4):278-80.
    PMID: 10487085
    Hyperimmunoglobulin E syndrome (HIE) is a rare condition characterised by marked elevation of serum IgE level, chronic dermatitis, intense pruritus, and recurrent serious infection. The major organism is usually S aureus. We report a case of an infant with HIE, who had pulmonary nocardiosis. The clinical features, immunological abnormalities, and radiological features of the condition are described. The child finally succumbed to the complications of pulmonary nocardiosis.
    Matched MeSH terms: Opportunistic Infections/diagnosis; Opportunistic Infections/genetics; Opportunistic Infections/immunology
  16. Ng SC, Hilmi IN, Blake A, Bhayat F, Adsul S, Khan QR, et al.
    Inflamm Bowel Dis, 2018 Oct 12;24(11):2431-2441.
    PMID: 30312414 DOI: 10.1093/ibd/izy153
    BACKGROUND: Vedolizumab (ENTYVIO) is a humanized α4β7 integrin antagonist approved for the treatment of inflammatory bowel disease, which selectively blocks gut-specific lymphocyte trafficking. We evaluated the risk of opportunistic infections of interest in patients treated with vedolizumab.

    METHODS: We determined the frequency of opportunistic infections and tuberculosis in patients receiving vedolizumab in phase 3 clinical trials and post-marketing settings. We also evaluated adverse events reported in the post-marketing setting in patients with a history of or concurrent hepatitis B/C virus infection.

    RESULTS: The incidence of opportunistic infections in patients receiving vedolizumab was 0.7 (GEMINI 1 and 2 clinical trials) and 1.0 (long-term safety study) per 100 patient-years, with 217 events reported in approximately 114,071 patient-years of exposure (post-marketing setting). Most opportunistic infections were nonserious and the majority of patients continued treatment with vedolizumab. Clostridium difficile was the most commonly reported infection, with an incidence rate of 0.5 per 100 patient-years (clinical trials). Tuberculosis was reported at 0.1 per 100 patient-years (clinical trials), with 7 events in the post-marketing setting. No tuberculosis-related deaths were reported in either setting. No cases of progressive multifocal leukoencephalopathy were reported. In 29 patients with a history of or concurrent hepatitis B/C infection in the post-marketing setting, no viral reactivation was observed.

    CONCLUSIONS: Clinical trials and post-marketing data showed that the rate of serious opportunistic infections in patients receiving vedolizumab was low and most patients could continue vedolizumab treatment. The frequency of tuberculosis infection was also low and no hepatitis B/C viral reactivation was reported.

    Matched MeSH terms: Opportunistic Infections/chemically induced; Opportunistic Infections/microbiology*; Opportunistic Infections/pathology
  17. Basavaprabhu A, Mahalingam S, Deepak M, Satish R
    Med J Malaysia, 2012 Apr;67(2):214-6.
    PMID: 22822648
    CNS toxoplasmosis presenting as hydrocephalus is a very rare entity. We present three cases of HIV positive patients whose brain imaging revealed hydrocephalus and who improved with anti toxoplasma medication along with intravenous steroids and did not require any CSF shunting procedures. The mechanism of hydrocephalus in CNS toxoplasmosis is usually due to compression of CSF outflow pathway by ring enhancing lesions but even in their absence hydrocephalus can be rarely seen due to ventriculitis. Hence in HIV positive patients with unexplained hydrocephalus CNS toxoplasmosis should be considered and such patients if started on treatment early have a good prognosis without requiring neurosurgical intervention.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/diagnosis*; AIDS-Related Opportunistic Infections/drug therapy
  18. Asmal HS, Mustafa M, Abdullah S, Zaidah AR, Nurhaslindawati AR, Sarimah A, et al.
    PMID: 20578464
    Pneumocystis pneumonia (PCP) has become the most common opportunistic infection in HIV/AIDS patients with a CD4 count < or = 200. The incidence of PCP has declined as a result of prophylaxis and better highly active antiretroviral therapy (HAART). The objective of this study was to review the demographic data of HIV patients diagnosed clinically as having PCP at the Hospital Raja Perempuan Zainab II (HRPZ II) in Malaysia. This was a prospective study. All HIV patients admitted to HRPZ II with respiratory symptoms were enrolled in this study after giving informed consent. Their demographic data were collected. The total number of HIV patients reviewed in this study was 107. Nearly 60% of patients were clinically diagnosed as having pneumocystis pneumonia based on their signs, symptoms and chest x-ray findings. A CD4 count was available in 83 out of 107 patients. The fifty-three percent of patients(44) had a CD4 < 200 and were clinically diagnosed as having pneumocystis pneumonia. Thirty percent had a CD4 < 200 but did not have clinical pneumocystis pneumonia. Sixteen point nine percent had a CD4 > 200 and had clinical pneumocystis pneumonia, three of whom had received HAART, four patients had received prophylaxis. Overall, 94 patients (87.8%) received prophylaxis for pneumocystis pneumonia. Thirty-three patients (30.8%) received HAART. The occurrence of pneumocystis pneumonia was common before full implementation of HAART. Pneumocystis pneumonia can occur in patients with a CD4 >200.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology*; AIDS-Related Opportunistic Infections/prevention & control
  19. Aziah AM
    Med J Malaysia, 2004 Mar;59(1):1-3.
    PMID: 15535327 MyJurnal
    Matched MeSH terms: AIDS-Related Opportunistic Infections/epidemiology; AIDS-Related Opportunistic Infections/prevention & control
  20. Shekhar KC, Ng KP, Rokiah I
    Med J Malaysia, 1993 Sep;48(3):355-60.
    PMID: 8183153
    An AIDS patient with multiple opportunistic infections (Candida, Pneumocystis carinii and Isospora belli) was identified at the University Hospital, Kuala Lumpur. The patient presented with profuse diarrhoea associated with lethargy, anorexia and weight loss. Routine stool examination showed Isospora belli oocysts. The infection responded to treatment with trimethroprim-sulfamethoxazole but relapse occurred 8 weeks later. This represents the first documented case of isosporiasis to occur in an AIDS patient in Malaysia.
    Matched MeSH terms: AIDS-Related Opportunistic Infections/drug therapy; AIDS-Related Opportunistic Infections/etiology*
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