Human parvovirus 4 in the bone marrow of Italian patients with AIDS.

Human parvovirus 4 (PARV4) is a recently discovered member of the Parvoviridae. We investigated the presence of this virus in bone-marrow aspirates of 35 Italian patients with AIDS. Viral DNA was detected by polymerase chain reaction in over 40% of patients (16/35).

Nongastroesophageal reflux disease-related infectious, inflammatory and injurious disorders of the esophagus.

Purpose Of Review: To review recently published studies presenting novel and relevant information on some esophageal infectious, inflammatory and injurious diseases.

Recent Findings: In the treatment of Candida esophagitis, fluconazole remains the treatment of choice, but clinical failures indicate new therapeutic opportunities, like two new echinocandins, micafungin and anidulafungin. Eosinophilic esophagitis is an increasingly recognized entity.

Clinical use of polymerase chain reaction performed on peripheral blood and bone marrow samples for the diagnosis and monitoring of visceral leishmaniasis in HIV-infected and HIV-uninfected patients: a single-center, 8-year experience in Italy and review of the literature.

Background: To overcome some of the limitations of conventional microbiologic techniques, polymerase chain reaction (PCR)-based assays are proposed as useful tools for the diagnosis of visceral leishmaniasis.

Patients And Methods: A comparative study using conventional microbiologic techniques (i.e.

Disseminated Penicillium marneffei infection in an HIV-positive Italian patient and a review of cases reported outside endemic regions.

We describe a case of disseminated Penicillium marneffei in a human immunodeficiency virus (HIV)-positive Italian man who stayed for 4 years in Chiang Ray province, northern Thailand. A review of the literature shows that penicilliosis, although unusual, may represent an emerging opportunistic infection among HIV-positive people traveling to endemic areas.

Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature.

We reviewed the clinical, microbiologic, and outcome characteristics of 72 patients with human immunodeficiency virus (HIV)-associated histoplasmosis (4 newly described) reported in Europe over 20 years (1984-2004). Seven cases (9.7%) were acquired in Europe (autochthonous), whereas the majority involved a history of travel or arrival from endemic areas.

Prospective observational study of fever in hospitalized returning travelers and migrants from tropical areas, 1997-2001.

Background: An estimated 50 million people each year from industrialized countries visit tropical areas: 3% to 11% of these travelers report a febrile illness on their return. We conducted a 5-year prospective observational study on the causes of fever in patients admitted to a university teaching hospital after returning from the tropics.

Methods: We enrolled in this study all consecutive patients admitted to the Division of Infectious Diseases of the University of Milan, Italy, between January 1997 and December 2001 presenting with fever (oral temperature > or =37.

[13C]Methionine breath test: a novel method to detect antiretroviral drug-related mitochondrial toxicity.

Objectives: A major side effect of antiretroviral drugs is nucleoside reverse transcriptase inhibitor (NRTI)-related mitochondrial toxicity, the in vivo diagnosis of which is difficult and not yet standardized. We used the [(13)C]methionine breath test to investigate hepatic mitochondrial oxidation in HIV-1-infected patients receiving antiretroviral therapy.

Patients And Methods: The [(13)C]methionine breath test was performed in healthy subjects (n=10), HIV-infected patients on antiretroviral therapy with (n=6) and without (n=15) hyperlactataemia and naive HIV-infected patients (n=11).

A 6 day course of liposomal amphotericin B in the treatment of infantile visceral leishmaniasis: the Italian experience.

Objectives: To evaluate in a retrospective analysis the efficacy and safety of a 6 day course of liposomal amphotericin B (L-AmB) in infantile cases of Mediterranean visceral leishmaniasis (VL) diagnosed over a 10 year period in Italy.

Patients And Methods: Patients included were diagnosed as having VL consecutively admitted from December 1992 to December 2001 at four main referral children's hospitals in Italy and treated with six intravenous doses of 3 mg/kg L-AmB given on days 1-5 and 10 (a total dose of 18 mg/kg). Demographic data, nutritional status, underlying diseases, clinical and laboratory findings, and therapy outcome were considered.

Discontinuation of maintenance therapy for cryptococcal meningitis in patients with AIDS treated with highly active antiretroviral therapy: an international observational study.

We conducted a retrospective, multicenter study evaluating the safety of discontinuing maintenance therapy for cryptococcal meningitis after immune reconstitution. Inclusion criteria were a previous definitive diagnosis of cryptococcal meningitis, a CD4 cell count of >100 cells/microL while receiving highly active antiretroviral therapy (HAART), and the subsequent discontinuation of maintenance therapy for cryptococcal meningitis. The primary end point was relapse of cryptococcal disease.

[Fungal infections in transplantation patients].

Invasive fungal infections have became one of the principal obstacles to successful solid organ and bone marrow transplantation. The natural history and incidence of systemic fungal infection varies with the type of organ transplanted and the immunosuppressive therapy administered; the majority of infections occur within the first two months after transplantation. The most common fungi that cause disease in transplant recipients are Candida spp.

HIV and direct damage of organs: disease spectrum before and during the highly active antiretroviral therapy era.

Evidence derived from numerous studies supports a primary role for HIV in the development of direct damage of different organs eventually being responsible for the appearance of dementia, cardiomyopathy, nephropathy and hematologic abnormalities. As a result of the introduction of effective antiretroviral combination therapies a dramatic decrease of AIDS-associated opportunistic infections and malignancies was observed; however, the role of HAART on HIV organ damage is less well appreciated. In this review we discuss the most common HIV-associated diseases, their pathogenesis as well as the possible changing scenery in the HAART era.

Disseminated microsporidiosis caused by Encephalitozoon cuniculi III (dog type) in an Italian AIDS patient: a retrospective study.

We report a case of disseminated microsporidiosis in an Italian woman with AIDS. This study was done retrospectively using formalin-fixed, paraffin-embedded tissue specimens obtained at autopsy. Microsporidia spores were found in the necrotic lesions of the liver, kidney, and adrenal gland and in ovary, brain, heart, spleen, lung, and lymph nodes.