Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Concomitant multiple mycobacterial infections in patients infected with HIV.
Abstr Gen Meet Am Soc Microbiol. 1994;94:624 (abstract no. V-38). Unique Identifier : AIDSLINE ASM94/94313125 Hafiz I; Pulvirenti J; Benson C; Kocka F; Cook County Hospital, Rush Medical College, Chicago, Illinois.
Abstract:
OBJECTIVE: Evaluate the epidemiology, clinical manifestations, and course of patients with multiple concomitant mycobacterial infections and determine associated risk factors. DESIGN: Retrospective chart review of all patients culture positive for two or more concomitant mycobacteria between 1991 and 1993. SETTING: Cook County Hospital (CCH), Chicago, Illinois, a public, county based hospital. METHODS: Charts were reviewed for all patients evaluated at CCH from 1991 to 1993 from whom two or more mycobacterial organisms were isolated. Data collected included sex, HIV risk factors, clinical presentation, laboratory abnormalities, CD4 counts, and site from which the organisms were recovered. RESULTS: Ten patients were identified with > or = 2 concomitant mycobacterial infections. 9/10 patients were HIV seropositive and one refused testing. None had a prior diagnosis of mycobacterial infection. Median age was 38 years, 9 were male and 1 female. HIV risk factors were IVDU (6), homosexuality (2), and multiple sex partners (2). Median CD4 cell count was 34 and 6/10 patients had a prior history of opportunistic infection. The most common mycobacterial combination was Mycobacterium tuberculosis and Mycobacterium avium complex (4/10). MAC was isolated more frequently from the blood (6/8) while M. tuberculosis (5/9) and M. kansasii (5/7) were more frequently isolated from sputum. Fever was the most common presenting symptom (8/10). Prognosis was poor especially for patients inadequately treated for all isolates. CONCLUSIONS: The patients most likely to have multiple concomitant mycobacterial infections were HIV-infected males with advanced immunosuppression. The most common symptom was fever. Mortality was high (5/10). Clinicians should be aware that HIV-infected patients with low CD4 cell counts (< 100) and positive AFB smears may be infected concomitantly with multiple mycobacteria.
Keywords: Adult AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/MICROBIOLOGY Comparative Study CD4-Positive T-Lymphocytes/IMMUNOLOGY Female Human HIV Seropositivity Male Mycobacterium avium-intracellulare Infection/COMPLICATIONS/ EPIDEMIOLOGY Mycobacterium Infections/COMPLICATIONS/*EPIDEMIOLOGY Retrospective Studies Risk Factors Sex Behavior Sex Factors Substance Abuse, Intravenous Tuberculosis/COMPLICATIONS/*EPIDEMIOLOGY ABSTRACT 941030
M94A0829
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
