Document 0149
 DOCN  M9480149
 TI    [HIV-associated histoplasmosis with pulmonary manifestation in Europe]
 DT    9410
 AU    Wockel W; Neher A; Morresi A; Pathologisches Institut,
       Zentralkrankenhaus Gauting der LVA; Oberbayern.
 SO    Dtsch Med Wochenschr. 1994 Jun 24;119(25-26):909-14. Unique Identifier :
       AIDSLINE MED/94291508
 AB    A 35-year-old man developed weight loss, lower abdominal pain,
       diarrhoea, cough, fever and general deterioration in his health. He had
       been born and resident in the USA until 1991, when he moved to Germany.
       Since 1991 he had known that he was HIV-positive. The chest radiograph
       showed bilateral diffuse spotty marking and a rounded cardiac
       silhouette, the latter echocardiographically due to pericardial
       effusion. Tuberculostatic drugs were started because miliary
       tuberculosis was suspected. But as his condition worsened and he was
       thought to have Pneumocystis pneumonia high doses of co-trimoxazole were
       administered. Perbronchial lung biopsy showed nonspecific chronic
       inflammatory changes. Periodide acid-Schiff reaction and Grocott
       staining demonstrated numerous histoplasma in alveolar macrophages and
       connective tissue. The organism was also cultured from bronchial
       secretions. Treatment was now changed to itraconazole (400 mg daily), 2
       weeks later changed to liposomal amphotericin B (100 mg daily) because
       of renewed fever. After 6 weeks the patient became free of symptoms and
       the radiological changes had largely regressed. To prevent recurrence,
       treatment with itraconazole (400 mg daily) is being continued.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY/
       ETHNOLOGY/PATHOLOGY  Biopsy  Case Report  Diagnosis, Differential  Drug
       Therapy, Combination  English Abstract  Germany/EPIDEMIOLOGY
       Histoplasma/ISOLATION & PURIF  Histoplasmosis/*DIAGNOSIS/DRUG
       THERAPY/ETHNOLOGY/PATHOLOGY  Human  Lung/MICROBIOLOGY/PATHOLOGY  Lung
       Diseases, Fungal/*DIAGNOSIS/DRUG THERAPY/ETHNOLOGY/PATHOLOGY  Male
       Nebraska/ETHNOLOGY  Pneumonia, Pneumocystis carinii/DIAGNOSIS
       Tuberculosis, Miliary/DIAGNOSIS  JOURNAL ARTICLE  REVIEW  REVIEW OF
       REPORTED CASES

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).