TY - JOUR
T1 - Disseminated infection due to mycobacterium aviumintracellulare in a homosexual man with kaposis sarcoma
AU - Fainstein, Victor
AU - Bolivar, R.
AU - Mavligit, G.
AU - Rios, A.
AU - Luna, M.
PY - 1982/1/1
Y1 - 1982/1/1
N2 - A 36-year-old single homosexual man with Kaposi's sarcoma was hospitalized for therapy for his malignancy. Histologic diagnosis was Kaposi's sarcoma of the skin and scalp. The lymph nodes showed caseating granulomas with numerous acid-fast bacilli, which were eventually identified as Mycobacterium avium-intracellulare that was resistant to antimycobacterial drugs. Treatment with isoniazid, ethambutol, and rifampin was begun; however, the tumor continued to spread. The patient died after developing disseminated intravascular coagulation, renal and hepatic failure, and candidemia. Postmortem examination revealed pneumonia due to CMV and microabscesses due to Candida and M. avium-intracellulare. The association of herpes-type viruses with human malignancies such as Burkitt's lymphoma, nasopharyngeal carcinoma, and cervical carcinoma has been well established. The fact that 90% of homosexual men have evidence of infection with CMV might suggest that CMV infection could be a triggering factor in the development of severe immunodeficiency, as shown in this patient. Infections due to P. carinii, Candida, atypical mycobacteria, and other organisms - as well as the development of unusual malignancies - might then be interpreted as logical consequences of this deficiency status.
AB - A 36-year-old single homosexual man with Kaposi's sarcoma was hospitalized for therapy for his malignancy. Histologic diagnosis was Kaposi's sarcoma of the skin and scalp. The lymph nodes showed caseating granulomas with numerous acid-fast bacilli, which were eventually identified as Mycobacterium avium-intracellulare that was resistant to antimycobacterial drugs. Treatment with isoniazid, ethambutol, and rifampin was begun; however, the tumor continued to spread. The patient died after developing disseminated intravascular coagulation, renal and hepatic failure, and candidemia. Postmortem examination revealed pneumonia due to CMV and microabscesses due to Candida and M. avium-intracellulare. The association of herpes-type viruses with human malignancies such as Burkitt's lymphoma, nasopharyngeal carcinoma, and cervical carcinoma has been well established. The fact that 90% of homosexual men have evidence of infection with CMV might suggest that CMV infection could be a triggering factor in the development of severe immunodeficiency, as shown in this patient. Infections due to P. carinii, Candida, atypical mycobacteria, and other organisms - as well as the development of unusual malignancies - might then be interpreted as logical consequences of this deficiency status.
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U2 - 10.1093/infdis/145.4.586
DO - 10.1093/infdis/145.4.586
M3 - Article
C2 - 6279739
AN - SCOPUS:0020471280
SN - 0022-1899
VL - 145
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -