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[Profound mycoses in AIDS in Abidjan (Côte d'Ivoire)]
S P Eholie1, L N'gbocho, E Bissagnene
1Service de maladies infectieuses et tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire.
Abstract:
During 1995, among 1105 HIV patients explored in our department, 64 presented a deep fungic infection (5.8%). The yeast was searched for in cerebrospinal fluid, blood, urine, and bronchoalveolar aspiration. Isolated germs were Cryptococcus neoformans (95%), Candida tropicalis (1 case), Saccharomyces cerevisiae (1 case) et Aspergillus fumigatus (1 case). Results of treatment with amphotericin B were: recovery (9%), clinical success (11%), out of sight (14%), letality (66%), relapse (23%) and side effects (19%). We emphasized diagnostical and therapeutical difficulties, and bad prognostic of mycoses in patients with AIDS.
Insights
Deep fungal infections affected 5.8% of HIV patients, with Cryptococcus neoformans being the most common. Treatment with amphotericin B showed high mortality and relapse rates, highlighting diagnostic and therapeutic challenges in AIDS patients.
Area of Science:
- Medical Mycology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Human Immunodeficiency Virus (HIV) infection significantly compromises the immune system, increasing susceptibility to opportunistic infections.
- Deep fungal infections are a major cause of morbidity and mortality in patients with advanced HIV/AIDS.
- Accurate and timely diagnosis of fungal infections is crucial for effective management in immunocompromised individuals.
Purpose of the Study:
- To determine the incidence and spectrum of deep fungal infections in HIV patients.
- To identify the etiological agents responsible for these infections.
- To evaluate the treatment outcomes and challenges associated with amphotericin B therapy.
Main Methods:
- Retrospective analysis of 1105 HIV patients from 1995.
- Microbiological investigation of cerebrospinal fluid, blood, urine, and bronchoalveolar aspirates for fungal pathogens.
- Assessment of treatment responses, including recovery, clinical success, mortality, relapse, and side effects.
Main Results:
- A prevalence of 5.8% (64/1105) for deep fungal infections was observed.
- Cryptococcus neoformans was the predominant isolate (95%), with rare cases of Candida tropicalis, Saccharomyces cerevisiae, and Aspergillus fumigatus.
- Amphotericin B treatment resulted in a 66% mortality rate, 23% relapse rate, and 19% incidence of side effects.
Conclusions:
- Deep fungal infections pose a significant threat to HIV patients, necessitating improved diagnostic and therapeutic strategies.
- The high mortality and relapse rates underscore the poor prognosis and treatment difficulties in this patient population.
- Further research is needed to develop more effective antifungal therapies and management protocols for HIV-associated mycoses.