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[Fungal infection in AIDS patients. Consideration for 10 cases]
Doina Mihalache1, Mihaela Lefter, V Luca
1Clinica Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.
Abstract:
Clinic, etiologic and therapeutic study of fungic infection in AIDS patients. The retrospective clinical study of the 10 AIDS patients admitted between 01.01.1994 and 31.12.2000 in Infectious Diseases Clinical Hospital of Iaşi. The majority of the cases (7) were registered in the last 3 years: 4 children and 6 adults. HIV infection was known only for 4 patients according to their history, and for the other 6 patients this diagnosis was made concomitantly of fungic infection diagnosis. The disease onset was insidious in 7 cases (2 children and 5 adults) being characterized by manifestations of nervous system involvement and consciousness disturbances (6 cases). The etiological diagnosis was established for alive patients by cerebrospinal fluid culture and hemocultures and Cryptococcus neoformans was isolated for 9 patients and Candida to another one. Fungic infection lead to meningeal injuries to 6 patients and the systemic one in for 4 patients. Although, under antifungical and antiretroviral therapy, the disease was lethal for 4 patients. The fungic infection recrudesces in AIDS patients, possessing systemic or/and meningeal manifestation, long evolution that can be lethal for a lot of them.
Insights
Fungal infections, often presenting with neurological symptoms, are a serious threat to AIDS patients. Early diagnosis and treatment are crucial, as these infections can be lethal despite therapy.
Area of Science:
- Infectious Diseases
- Mycology
- Neurology
Background:
- Fungal infections pose a significant risk to individuals with Acquired Immunodeficiency Syndrome (AIDS).
- These infections can manifest with severe neurological complications and systemic involvement.
- The incidence of fungal infections in AIDS patients has been observed to increase.
Purpose of the Study:
- To investigate the clinical, etiological, and therapeutic aspects of fungal infections in a cohort of AIDS patients.
- To identify the causative fungal agents and their clinical presentations.
- To evaluate treatment outcomes and mortality rates.
Main Methods:
- A retrospective clinical study of 10 AIDS patients admitted to the Infectious Diseases Clinical Hospital of Iaşi between 1994 and 2000.
- Etiological diagnosis was established through cerebrospinal fluid and blood cultures.
- Patient data were analyzed for clinical manifestations, treatment, and outcomes.
Main Results:
- Cryptococcus neoformans was the predominant fungal pathogen, isolated in 9 out of 10 patients.
- Fungal infections led to meningeal involvement in 6 patients and systemic disease in 4.
- Neurological symptoms and consciousness disturbances were common presenting features.
- Despite antifungal and antiretroviral therapy, 4 patients (40%) succumbed to the infection.
Conclusions:
- Fungal infections, particularly cryptococcosis, frequently occur in AIDS patients, often with severe meningeal or systemic manifestations.
- These infections have a prolonged course and a high potential for lethality in this vulnerable population.
- Prompt diagnosis and combined antifungal and antiretroviral therapy are essential but do not guarantee survival.