Document 0820
 DOCN  M9480820
 TI    Concomitant multiple mycobacterial infections in patients infected with
       HIV.
 DT    9410
 AU    Hafiz I; Pulvirenti J; Benson C; Kocka F; Cook County Hospital, Rush
       Medical College, Chicago, Illinois.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:624 (abstract no. V-38). Unique
       Identifier : AIDSLINE ASM94/94313125
 AB    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.
 DE    Adult  AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/MICROBIOLOGY
       Comparative Study  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
       T4 Lymphocytes/IMMUNOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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