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1994-09-05
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Document 0820
DOCN M9480820
TI Concomitant multiple mycobacterial infections in patients infected with
HIV.
DT 9410
AU Hafiz I; Pulvirenti J; Benson C; Kocka F; Cook County Hospital, Rush
Medical College, Chicago, Illinois.
SO Abstr Gen Meet Am Soc Microbiol. 1994;94:624 (abstract no. V-38). Unique
Identifier : AIDSLINE ASM94/94313125
AB OBJECTIVE: Evaluate the epidemiology, clinical manifestations, and
course of patients with multiple concomitant mycobacterial infections
and determine associated risk factors. DESIGN: Retrospective chart
review of all patients culture positive for two or more concomitant
mycobacteria between 1991 and 1993. SETTING: Cook County Hospital (CCH),
Chicago, Illinois, a public, county based hospital. METHODS: Charts were
reviewed for all patients evaluated at CCH from 1991 to 1993 from whom
two or more mycobacterial organisms were isolated. Data collected
included sex, HIV risk factors, clinical presentation, laboratory
abnormalities, CD4 counts, and site from which the organisms were
recovered. RESULTS: Ten patients were identified with > or = 2
concomitant mycobacterial infections. 9/10 patients were HIV
seropositive and one refused testing. None had a prior diagnosis of
mycobacterial infection. Median age was 38 years, 9 were male and 1
female. HIV risk factors were IVDU (6), homosexuality (2), and multiple
sex partners (2). Median CD4 cell count was 34 and 6/10 patients had a
prior history of opportunistic infection. The most common mycobacterial
combination was Mycobacterium tuberculosis and Mycobacterium avium
complex (4/10). MAC was isolated more frequently from the blood (6/8)
while M. tuberculosis (5/9) and M. kansasii (5/7) were more frequently
isolated from sputum. Fever was the most common presenting symptom
(8/10). Prognosis was poor especially for patients inadequately treated
for all isolates. CONCLUSIONS: The patients most likely to have multiple
concomitant mycobacterial infections were HIV-infected males with
advanced immunosuppression. The most common symptom was fever. Mortality
was high (5/10). Clinicians should be aware that HIV-infected patients
with low CD4 cell counts (< 100) and positive AFB smears may be infected
concomitantly with multiple mycobacteria.
DE Adult AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/MICROBIOLOGY
Comparative Study Female Human HIV Seropositivity Male
Mycobacterium avium-intracellulare Infection/COMPLICATIONS/
EPIDEMIOLOGY Mycobacterium Infections/COMPLICATIONS/*EPIDEMIOLOGY
Retrospective Studies Risk Factors Sex Behavior Sex Factors
Substance Abuse, Intravenous Tuberculosis/COMPLICATIONS/*EPIDEMIOLOGY
T4 Lymphocytes/IMMUNOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).