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Scary New Bugs
Watch for unusual HIV infections.
Although the rate of HIV-related infections has dramatically declined in the United States and Europe due to the advent of triple-drug therapy, new and unusual diseases continue to crop up. That's partly due to the contribution of geography, global travel, and sex.  Elsewhere in the world, individuals with HIV often develop infections from parasites that are common in their local areas. These infections are now crossing borders. Here's a sample:
- Diarrhea culprit: Clostridium difficile is a bacteria that's turned up in many Peruvians with HIV and appears to play a role in HIV-related diarrhea, says Dr. Field F. Willingham of the John Hopkins University School of Hygiene and Public Health in Baltimore. The bug was the most prevalent of several pathogens in AIDS patients surveyed, causing a sixfold increase in diarrhea-associated mortality.
- More Global Bugs: P. marneffei infection causes fever, diarrhea, night sweats, and malaise. It is found in HIV-positive individuals in Southeast Asia and is being transmitted to individuals abroad, say researchers at Prince of Wales Hospital in England. Amphotericin B plus oral itraconazole is a new first-line therapy. Across the globe, Pseudallescheria boydii, a fungus found in moist soil, was discovered in an Argentinean HIV-positive patient suffering from headaches and seizures.
- Brain Drain: An "unexplained" degenerative disorder of the cerebellum, unlinked to HIV dementia, was reported in 10 HIV-positive patients over an eight-year period by researchers at Mt. Sinai Medical Center in New York in January. They speculate the cause to be HIV or related inflammatory products such as cytokines or chemokines.
o Mystery Parasite: It looks like a strange mass of tissue but may be related to a tapeworm. Stanford University researchers report a frightening case of a tissue mass found in the gut and liver of an AIDS patient that they mistook for lymphomatous masses. The aggressive invader doesn't respond to conventional therapy.
- Rhodococcus? Toledo, Ohio, researchers recently treated a 46-year old U.S. AIDS patient who had colonic polyps (growths in colon) and disseminated infection associated with Rhodococcus equi. The man also suffered from short-term memory loss and personality changes; a cerebral scan showed multiple lesions in his brain. Intensive daily therapy cleared the infection, but new lesions were found after therapy was temporarily ended.
- Rhinosporidiosis: An organism common to southern India, rhinosporidiosis turned up recently in a U.S. male, age 33, and could be a new opportunistic infection, say Temple, Texas, researchers.
-Anne-christine d'Adesky
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