Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: a case report and review of literature

<p>Abstract</p> <p>Backgrounds</p> <p>Disseminated <it>Penicillium marneffei </it>infection is one of the most common HIV-related opportunistic infections in Southeast Asia. Immune reconstitution inflammatory syndrome (IRIS) is a complication related to antiretroviral therapy (ART)-induced immune restoration. The aim of this report is to present a case of HIV-infected child who developed an unmasking type of IRIS caused by disseminated <it>P. marneffei </it>infection after ART initiation.</p> <p>Case presentation</p> <p>A 14-year-old Thai HIV-infected girl presented with high-grade fever, multiple painful ulcerated oral lesions, generalized non-pruritic erythrematous skin papules and nodules with central umbilication, and multiple swollen, warm, and tender joints 8 weeks after ART initiation. At that time, her CD4⁺cell count was 7.2% or 39 cells/mm³. On admission, her repeated CD4⁺cell count was 11% or 51 cells/mm³and her plasma HIV-RNA level was < 50 copies/mL. Her skin biopsy showed necrotizing histiocytic granuloma formation with neutrophilic infiltration in the upper and reticular dermis. Tissue sections stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and Grocott methenamine silver (GMS) stain revealed numerous intracellular and extracellular, round to oval, elongated, thin-walled yeast cells with central septation. The hemoculture, bone marrow culture, and skin culture revealed no growth of fungus or bacteria. Our patient responded well to intravenous amphotericin B followed by oral itraconazole. She fully recovered after 4-month antifungal treatment without evidence of recurrence of disease.</p> <p>Conclusions</p> <p>IRIS from <it>P. marneffei </it>in HIV-infected people is rare. Appropriate recognition and properly treatment is important for a good prognosis.</p

Current status of freshwater prawn culture in Vietnam and the development and transfer of seed production technology

In Vietnam, the giant freshwater prawn Macrobrachium rosenbergii is becoming an increasingly important targeted species, as its culture, especially in rice fields, is considered to have the potential to raise income among impoverished farmers. The production of M. rosenbergii based on aquaculture reached over 10 000 tons per year in 2002, having increased from about 2500 tons since the 1990s. Until recently, lack of a stable supply of seed had been an important obstacle to the further expansion and development of M. rosenbergii culture, but cumulative research on larval rearing, especially in the 1990s, has led to the development of new seed production technology based on the 'modified stagnant green water system'. Following its dissemination by the efforts of provincial authorities, hatchery operators, and farmers, the freshwater prawn seed production industry developed rapidly in the Mekong Delta with over 90 hatcheries producing 76.5 million postlarvae in 2003. This is considered to have affected the expansion of rice-prawn farming in the Mekong Delta, leading to increased aquacultural production in the region. This paper reviews the current status of freshwater prawn culture in Vietnam and background history, and presents a socioeconomic evaluation of seed production technology implementation

Heterogeneous catalyst ozonation of Direct Black 22 from aqueous solution in the presence of metal slags originating from industrial solid wastes

© 2019 Elsevier B.V. This study developed a low cost catalyst, namely, zinc slag (Zn-S) for the ozonation process of Direct Black 22 (DB22) from aqueous solutions. Among five different kind of low cost metal slags including Fe-S, Cu-S, Cd-S, Pb-S and Zn-S, the Zn-S slag was selected as an efficient catalyst in this study. Zn-S contained mainly zinc (Zn) and calcium (Ca) discharged from zinc slag waste in Vietnam. It was found that Zn-S could effectively decolonize and mineralize DB22 through heterogeneous catalytic ozonation. The degradation kinetic of DB22 followed the pseudo-first order model. The best removal efficiency of DB22 (Zn-S/O3/H2O2 (76%) > Zn-S/O3 (69%) > O3/H2O2 (66%) > O3 (55% for COD) occurred at pH 11 for heterogeneous catalytic ozonation processes with Zn-S as the catalyst as well as ozone alone and perozone processes due to fast decomposition of O3 in alkaline solution to generate powerful and non-selective OH radicals. An increase in decolonization and mineralization rate was observed when increasing the Zn-S dosage from 0.125 g/L to 0.75 g/L for Zn-S/O3 and 0.125 g/L to 1.0 g/L for Zn-S/O3/H2O2. The K values of the pseudo-first order model followed the same sequence as mineralization rates of DB22 in term of COD removal. Ca and Zn constituents in the Zn-S catalyst contributed to the increase in O3 decomposition and improvement of reaction rate with H2O2. Subsequently, the degradation of DB22 by the ozonation process with Zn-S catalyst was enhanced through the enrichment mechanism of hydroxyl radicals (*OH) and surface adsorption. The degradation mechanism of DB22 by hydroxyl radicals was surely affirmed by tests with the decrease in degradation percentage of DB22 in case of the presence t-butanol, Cl− and CO32−

Timing of CD8+ T cell responses in relation to commencement of capillary leakage in children with dengue.

Immune activation is a feature of dengue hemorrhagic fever (DHF) and CD8+ T cell responses in particular have been suggested as having a role in the vasculopathy that characterizes this disease. By phenotyping CD8+ T cells (CD38+/HLA-DR+, CD38+/Ki-67+, or HLA-DR+/Ki-67+) in serial blood samples from children with dengue, we found no evidence of increased CD8+ T cell activation prior to the commencement of resolution of viremia or hemoconcentration. Investigations with MHC class I tetramers to detect NS3(133-142)-specific CD8+ T cells in two independent cohorts of children suggested the commencement of hemoconcentration and thrombocytopenia in DHF patients generally begins before the appearance of measurable frequencies of NS3(133-142)-specific CD8+ T cells. The temporal mismatch between the appearance of measurable surface activated or NS3(133-142)-specific CD8+ T cells suggests that these cells are sequestered at sites of infection, have phenotypes not detected by our approach, or that other mechanisms independent of CD8+ T cells are responsible for early triggering of capillary leakage in children with DHF

Fluid replacement in dengue shock syndrome: a randomized, double-blind comparison of four intravenous-fluid regimens.

Dengue hemorrhagic fever and dengue shock syndrome (DSS) are major causes of childhood morbidity and mortality in many tropical countries. Increased intravascular permeability leading to shock is the cardinal feature of DSS. Fluid resuscitation to counteract massive plasma leakage is the mainstay of treatment. A double-blind, randomized trial comparing four intravenous-fluid regimens for acute resuscitation of 50 children with DSS was conducted. Colloids (dextran 70 or the protein digest gelafundin 35,000) restored cardiac index and blood pressure and normalized hematocrit more rapidly than crystalloids (Ringer's lactate or 0.9%-weight/volume saline). Dextran 70 provided the most rapid normalization of the hematocrit and restoration of the cardiac index, without adverse effects, and may be the preferred solution for acute resuscitation in DSS. Further large-scale double-blind trials are required to provide an evidence-based approach to the management of DSS

Immunological and biochemical correlates of adjunctive dexamethasone in Vietnamese adults with bacterial meningitis.

Adjunctive treatment to improve outcome from bacterial meningitis has centered on dexamethasone. Among Vietnamese patients with bacterial meningitis, cerebrospinal fluid (CSF) opening pressure and CSF:plasma glucose ratios were significantly improved and levels of CSF cytokines interleukin (IL)-6, IL-8, and IL-10 and were all statistically significantly lower after treatment in patients who were randomized to dexamethasone, compared with levels in patients who received placebo

Temporal fluctuation of multidrug resistant salmonella typhi haplotypes in the mekong river delta region of Vietnam.

BACKGROUND: typhoid fever remains a public health problem in Vietnam, with a significant burden in the Mekong River delta region. Typhoid fever is caused by the bacterial pathogen Salmonella enterica serovar Typhi (S. Typhi), which is frequently multidrug resistant with reduced susceptibility to fluoroquinolone-based drugs, the first choice for the treatment of typhoid fever. We used a GoldenGate (Illumina) assay to type 1,500 single nucleotide polymorphisms (SNPs) and analyse the genetic variation of S. Typhi isolated from 267 typhoid fever patients in the Mekong delta region participating in a randomized trial conducted between 2004 and 2005. PRINCIPAL FINDINGS: the population of S. Typhi circulating during the study was highly clonal, with 91% of isolates belonging to a single clonal complex of the S. Typhi H58 haplogroup. The patterns of disease were consistent with the presence of an endemic haplotype H58-C and a localised outbreak of S. Typhi haplotype H58-E2 in 2004. H58-E2-associated typhoid fever cases exhibited evidence of significant geo-spatial clustering along the Sông H u branch of the Mekong River. Multidrug resistance was common in the established clone H58-C but not in the outbreak clone H58-E2, however all H58 S. Typhi were nalidixic acid resistant and carried a Ser83Phe amino acid substitution in the gyrA gene. SIGNIFICANCE: the H58 haplogroup dominates S. Typhi populations in other endemic areas, but the population described here was more homogeneous than previously examined populations, and the dominant clonal complex (H58-C, -E1, -E2) observed in this study has not been detected outside Vietnam. IncHI1 plasmid-bearing S. Typhi H58-C was endemic during the study period whilst H58-E2, which rarely carried the plasmid, was only transient, suggesting a selective advantage for the plasmid. These data add insight into the outbreak dynamics and local molecular epidemiology of S. Typhi in southern Vietnam