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M9480149.TXT
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1994-08-09
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Document 0149
DOCN M9480149
TI [HIV-associated histoplasmosis with pulmonary manifestation in Europe]
DT 9410
AU Wockel W; Neher A; Morresi A; Pathologisches Institut,
Zentralkrankenhaus Gauting der LVA; Oberbayern.
SO Dtsch Med Wochenschr. 1994 Jun 24;119(25-26):909-14. Unique Identifier :
AIDSLINE MED/94291508
AB A 35-year-old man developed weight loss, lower abdominal pain,
diarrhoea, cough, fever and general deterioration in his health. He had
been born and resident in the USA until 1991, when he moved to Germany.
Since 1991 he had known that he was HIV-positive. The chest radiograph
showed bilateral diffuse spotty marking and a rounded cardiac
silhouette, the latter echocardiographically due to pericardial
effusion. Tuberculostatic drugs were started because miliary
tuberculosis was suspected. But as his condition worsened and he was
thought to have Pneumocystis pneumonia high doses of co-trimoxazole were
administered. Perbronchial lung biopsy showed nonspecific chronic
inflammatory changes. Periodide acid-Schiff reaction and Grocott
staining demonstrated numerous histoplasma in alveolar macrophages and
connective tissue. The organism was also cultured from bronchial
secretions. Treatment was now changed to itraconazole (400 mg daily), 2
weeks later changed to liposomal amphotericin B (100 mg daily) because
of renewed fever. After 6 weeks the patient became free of symptoms and
the radiological changes had largely regressed. To prevent recurrence,
treatment with itraconazole (400 mg daily) is being continued.
DE Adult AIDS-Related Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY/
ETHNOLOGY/PATHOLOGY Biopsy Case Report Diagnosis, Differential Drug
Therapy, Combination English Abstract Germany/EPIDEMIOLOGY
Histoplasma/ISOLATION & PURIF Histoplasmosis/*DIAGNOSIS/DRUG
THERAPY/ETHNOLOGY/PATHOLOGY Human Lung/MICROBIOLOGY/PATHOLOGY Lung
Diseases, Fungal/*DIAGNOSIS/DRUG THERAPY/ETHNOLOGY/PATHOLOGY Male
Nebraska/ETHNOLOGY Pneumonia, Pneumocystis carinii/DIAGNOSIS
Tuberculosis, Miliary/DIAGNOSIS JOURNAL ARTICLE REVIEW REVIEW OF
REPORTED CASES
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).