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Published on: February 14, 2011

Actinomycetales infection in the acquired immunodeficiency syndrome

H A Holtz, D P Lavery, R Kapila

    Annals of Internal Medicine
    |February 1, 1985
    PubMed

    Insights

    Parenteral drug abusers with acquired immunodeficiency syndrome (AIDS) can develop serious nonmycobacterial actinomycetales infections like nocardiosis and streptomyces. These infections pose significant risks, underscoring the need for accurate diagnosis in immunocompromised patients.

    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Immunocompromised Hosts

    Background:

    • Acquired immunodeficiency syndrome (AIDS) is a significant risk factor for opportunistic infections.
    • Nonmycobacterial actinomycetales, including Nocardia and Streptomyces species, are emerging pathogens in immunocompromised individuals.
    • Parenteral drug abuse is associated with increased susceptibility to various infections.

    Observation:

    • Four cases of nonmycobacterial actinomycetales infections were identified in parenteral drug abusers with AIDS.
    • Infections included nocardiosis (three patients) and Streptomyces lymphadenitis (one patient).
    • Pericardial involvement was noted in two patients, and two patients unfortunately died.

    Findings:

    • Presumptive diagnoses were frequently incorrect, indicating challenges in identifying these infections.
    • A significant proportion of patients with AIDS and these infections (4 out of 9) also had concurrent mycobacterial disease.
    • These findings suggest a potential common susceptibility to actinomycetales and mycobacteria in immunosuppressed patients.

    Implications:

    • The study highlights the diagnostic difficulties and risks associated with empiric therapy for infections in this patient population.
    • Early and accurate diagnosis is crucial for effective treatment of nonmycobacterial actinomycetales infections in AIDS patients.
    • Further research is warranted to understand the shared susceptibility factors and optimize management strategies for opportunistic infections in immunocompromised individuals.

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