Related Experiment Video
Updated: Jul 31, 2026
08:14
An In Vitro Model for Measuring Immune Responses to Malaria in the Context of HIV Co-infection
Published on: October 6, 2015
Nocardiasis in patients with HIV infection
F Márquez-Diaz1, L E Soto-Ramirez, J Sifuentes-Osornio
1Department of Infectious Diseases, Instituto Nacional de la Nutrición, Tlalpan, Mexico.
AIDS Patient Care and Stds
|May 22, 2001
Summary
Nocardia infections are increasing in HIV patients and can mimic tuberculosis. Suspect nocardiasis in HIV patients unresponsive to TB treatment, IV drug users, or those with pericardial infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Nocardia infections present a growing concern in human immunodeficiency virus (HIV)-infected populations.
- The incidence of Nocardia infection in HIV patients rose from 0.3% in 1985 to 1.8% in 1989.
- Nocardiasis can be mistaken for other pulmonary infections like tuberculosis (TB) due to nonspecific symptoms, posing a diagnostic challenge.
Observation:
- A tertiary care center in Mexico City diagnosed three cases of nocardiasis among 1060 HIV-infected patients between 1981 and 1997.
- All diagnosed patients were homosexual men with a mean age of 32 years and CD4 counts below 260 cells/mm³.
- Clinical presentations varied, including subacute sinusitis, abdominal abscess, and disseminated nocardiasis, often with co-infections like TB, cytomegalovirus (CMV), and Mycobacterium avium complex (MAC).
Findings:
- Trimethoprim/sulfamethoxazole (TMP/SMX) was the primary treatment, with a 66% survival rate in the observed cases.
- A literature review identified 130 cases of Nocardia infection in HIV patients since 1982.
- Nocardiasis should be suspected in HIV patients unresponsive to antitubercular therapy, intravenous drug users, or those with pericardial infections.
Implications:
- Early diagnosis and treatment of nocardiasis are crucial, given its potential for high mortality (up to 60%).
- Diagnostic suspicion should be heightened in specific HIV patient subgroups.
- Surgical or percutaneous drainage of abscesses is vital for both diagnosis and therapeutic management of nocardiasis.
Related Concept Videos
01:10Retrovirus Life Cycles
Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...
01:14Myocarditis III: Medical Management
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
01:29Cardiomyopathy VI: Nursing Management
Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...