[Non-typhic Salmonella bacteremias in HIV infections. Clinical and therapeutic data, and course in 68 patients].
Between 1982 and 1989, a retrospective study on non typhi Salmonella bacteremias was performed among patients infected with human immunodeficiency virus hospitalized in 4 departments of Infectious and Tropical Diseases in Paris. The population included 59 men and 9 women; 26.4 percent had been contamined with HIV by heterosexual contact; 17.6 percent originated from Africa or Haiti. Clinical symptoms were fever (100 percent of the cases), present since less than 5 days (65 percent of the cases), and gastrointestinal symptoms, present in 53 percent of the patients. Blood cultures were positive in all cases; Salmonella was less frequently found in other sites: stools (n = 13, 19 percent), urine (n = 5), lymph nodes (n = 1), sputum (n = 1). Mean CD4 cell count was 118 +/- 145/mm3. The serotypes were mainly S. typhimurium (n = 26), S. enteritidis (n = 23), and S. dublin (n = 15). Under antibiotic therapy, the course of the disease was initially favorable in 98.5 percent of the cases. One patient died of septic shock. At least one relapse occurred in 17 percent of the patients, 2.1 +/- 1.6 months after the end of the initial therapy. No relapse was observed in patients taking zidovudine or antibioprophylaxis, but 53 percent of the patients without antibioprophylaxis relapsed (P less than 0.001). The overall survival of the cohort was 25 percent after 18 months. These results show the poor prognosis of a first episode of Salmonella bacteremia in HIV infected patients, making the diagnosis of AIDS highly probable if cellular immunity is markedly impaired.
Salmon-Ceron
D
D
Service des Maladies infectieuses et tropicales, Hôpital Bichat-Claude Bernard, Paris.
Detruchis
P
P
Jaccard
A
A
Leport
C
C
Karam-Sarkis
D
D
Rosenbaum
W
W
Meyohas
M C
MC
Coulaud
J P
JP
Vildé
J L
JL
D042462:4-Quinolones; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D002511:Cephalosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D010406:Penicillins / Q000627:therapeutic use; D012189:Retrospective Studies; D012475:Salmonella / Q000187:drug effects / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D012477:Salmonella enteritidis / Q000187:drug effects / Q000302:isolation & purification; D012486:Salmonella typhimurium / Q000187:drug effects / Q000302:isolation & purification; D015215:Zidovudine / Q000494:pharmacology
D042462:4-Quinolones; D000890:Anti-Infective Agents; D002511:Cephalosporins; D010406:Penicillins; D015215:Zidovudine
Bactériémies à salmonelles non typhiques au cours de l'infection par le VIH. Données cliniques, évolutives et thérapeutiques chez 68 malades.