Out of Sight But Not Out of Mind

Abstract

Clinicians have had some success in treating or preventing several rarely discussed opportunistic infections. The author discusses seven infections, outlining the disease and possible treatments. Aspergillosis, a fungal infection found in the lungs and sinuses, can be treated with intravenous amphotericin B. However, researchers are studying oral itraconazole as an alternative treatment. B-19 parvovirus is a viral infection that may cause severe anemia, a decrease in red blood cell count or hemoglobin. A small study suggests that IVIG (intravenous immune globulin) was effective in reversing B-19 parvovirus-related anemia in seven HIV-positive patients. Coccidioidomycosis, an uncommon fungal infection usually seen in the lungs, has symptoms closely resembling those of PCP. Treatments include amphotericin B, or ketoconazole or fluconazole for mild cases. Histoplasmosis usually occurs in AIDS patients with fewer than 100 CD4 cells. A fungal infection, histoplasmosis can be treated with amphotericin V and itraconazole. Isosporiasis invades the intestines, causing persistent, watery diarrhea and other symptoms resembling cryptosporidiosis. Sulfadoxine and pyrimethamine combined can prevent the return of the organism. Molluscum contagiosum is a viral infection that produces small, white wart-like bumps on the skin. Bumps can be removed with an electrical charge or with liquid nitrogen. Progressive multifocal leukoencephalopathy (PML) is a life-threatening brain disorder. A very small study suggests that patients who received cytosine arabinoside (ara-C, cytarabine) stabilized and improved after treatment.