Multiple opportunistic fungal infections in an individual with severe HIV disease: A case report |
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| Institution: | 1. Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil;2. Serviço de Anatomia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil;3. Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain;1. Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan;2. Department of Pumonary Medicine, Aga Khan University Hospital, Karachi, Pakistan;1. Ehime University School of Medicine, Japan;2. Department of Clinical Oncology, Ehime University Graduate School of Medicine, Japan;1. Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), Faculté de Médecine, Aix Marseille Université, 13385 Marseille cedex 5, France;1. University of Gondar-College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia;2. Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia;1. Universidade Federal do Rio de Janeiro, Rio de Janeiro;2. Universidade Federal da Bahia, Salvador;3. Universidade Federal Fluminense, Niterói;4. Funda ção Oswaldo Cruz;5. Hospital Couto Maia, Salvador;6. Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil;7. University of California, Berkeley, CA, USA;1. Department of Anesthesiology and Intensive Care, Military Hospital Sainte-Anne, 2, boulevard Sainte-Anne, BP 600, 83000 Toulon, France;2. Department of Neurology, Military Hospital Sainte-Anne, 83000 Toulon, France;3. École du Val de Grâce, 75230 Paris, France |
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| Abstract: | BackgroundFungal infections have been commonly diagnosed in individuals with advanced HIV disease. Cryptococcosis, pneumocystosis, and histoplasmosis are the most frequent systemic mycoses in people suffering from HIV/AIDS.Case reportWe report a case of multiple fungal infections in an advanced AIDS-patient. A 33-year-old HIV-positive man from Brazil was hospitalized due to diarrhea, dyspnea, emaciation, hypoxemia, extensive oral thrush, and a CD4+ T lymphocyte count of 20 cells/mm3. Honeycombed-structures consistent with Pneumocystis jirovecii were observed by direct immunofluorescence in induced sputum. Cryptococcus neoformans was recovered from respiratory secretion and cerebrospinal fluid cultures. Histopathology of the bone marrow also revealed the presence of Histoplasma capsulatum. Molecular assays were performed in a sputum sample. Nested-PCR confirmed the presence of P. jirovecii and H. capsulatum; qPCR multiplex was positive for C. neoformans and H. capsulatum. With the treatment of antifungal drugs the patient progressed satisfactorily.ConclusionsThe diagnosis of several systemic mycoses demonstrates the vulnerability of advanced AIDS-patients. Thus, the detection of AIDS cases in the early stages of infection is necessary for a prompt and adequate introduction of HAART therapy, and the use of prophylaxis to control opportunistic infections. |
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| Keywords: | Pneumocystosis Cryptococcosis Histoplasmosis AIDS Immune response inflammatory syndrome Neumocistosis Criptococosis Histoplasmosis Sida Síndrome inflamatorio de reconstitución inmune |
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