Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area.
Eight cases of typhoid and paratyphoid fever were identified during a 4-year period in a cohort of 117 patients who were positive for human immunodeficiency virus in Lima, Peru. Asymptomatic patients with human immunodeficiency virus infection and patients with the lymphadenopathy syndrome had a typical clinical presentation and response to therapy. Patients with the acquired immunodeficiency syndrome who were culture positive for Salmonella typhi or Salmonella paratyphi presented with fulminant diarrhea and/or colitis; the two patients for whom at least 2 months of follow-up were available relapsed. In our cohort there were 0.06 cases of typhoid or paratyphoid per patient year of observation; this rate is approximately 60 times that in the general population in Lima, and 25 times that in the 15- to 35-year-old age group. Our data indicate that patients who are positive for human immunodeficiency virus are at significantly increased risk for infection with S typhi and S paratyphi, and suggest that the clinical presentation of these diseases in patients with the acquired immunodeficiency syndrome differs from that seen immunocompetent hosts.
Gotuzzo
E
E
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Perfuana Cayetano Heredia, Lima, Peru.
Frisancho
O
O
Sanchez
J
J
Liendo
G
G
Carrillo
C
C
Black
R E
RE
Morris
J G
JG
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010284:Paratyphoid Fever / Q000150:complications* / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D012008:Recurrence; D012484:Salmonella paratyphi B; D014435:Typhoid Fever / Q000150:complications* / Q000453:epidemiology