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Concurrent salmonellosis and histoplasmosis in AIDS: an unusual co-existence in Britain

S Crowley1, R J Coker, S M Murphy

  • 1Department of Genitourinary Medicine, Patrick Clements Clinic, Central Middlesex Hospital, London, UK.

Genitourinary Medicine
|August 1, 1992
PubMed

Insights

Systemic salmonellosis unresponsive to treatment suggests a potential secondary infection. Histoplasma capsulatum identified post-mortem indicates reticuloendothelial system dysfunction may have impacted the patient's outcome.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunology

Background:

  • Systemic salmonellosis is a severe bacterial infection requiring prompt antimicrobial therapy.
  • Reticuloendothelial system (RES) dysfunction can impair host defense mechanisms.
  • Histoplasma capsulatum is an opportunistic fungal pathogen.

Observation:

  • A patient presented with systemic salmonellosis that did not respond to standard treatment.
  • The patient's condition deteriorated despite therapeutic interventions.
  • Post-mortem examination revealed the presence of Histoplasma capsulatum.

Findings:

  • Histoplasma capsulatum was isolated from the patient after death.
  • The fungal infection was not initially suspected or diagnosed during the patient's illness.
  • The presence of H. capsulatum suggests a potential role in the patient's unresponsiveness to salmonellosis therapy.

Implications:

  • Fungal infections, such as histoplasmosis, can complicate bacterial infections like salmonellosis.
  • RES dysfunction caused by H. capsulatum may compromise the immune response to other pathogens.
  • This case highlights the importance of considering opportunistic infections in immunocompromised or critically ill patients.
  • Altered prognosis in severe salmonellosis could be linked to concurrent opportunistic fungal infections impacting immune function.

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