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ABSTRACT: We determined the seroprevalence of latent cytomegalovirus (CMV) infection among young and elderly adults to test for a change in seroprevalence with increasing age. Thirty-two young and 32 elderly adults were tested for anti-CMV IgG, T-cell subgroup analysis, mental status and daily life activity. There was no significant difference in the seroprevalence of CMV infection between the two groups (59.4% vs 50.0%; p = 0.616). The subgroup analysis of T-cells showed significantly lower percentages of CD3 (64.5 +/- 9.5% vs 69.0 +/- 4.5%; p = 0.019) and CD8 (20.6 +/- 7.3% vs 28.3 +/- 6%; p < 0.001), and a higher percentage of CD4 (42.2 +/- 7.5% vs 36.5 +/- 4.7%; p = 0.001) cells in the elderly group. No differences in T-cell subgroups were observed by CMV serostatus subgroup among the young and elderly adult groups. Among the elderly there was a significantly lower mental status examination score among CMV positive subjects than CMV negative subjects (27.7 and 28.8 respectively, p = 0.049), but no difference in the advanced daily life activity index between the two groups. These results suggest the prevelence of CMV infection in elderly Thais does not increase with age and is not associated with immune status; however, the presence of latent CMV infection in the elderly may be associated with a decline in mental status, but not the inability to carry out activities of daily living. Further studies with large number of patients are needed to explore these findings.
The Southeast Asian journal of tropical medicine and public health 11/2012; 43(6):1419-25. · 0.60 Impact Factor
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ABSTRACT: This is a case report of a patient with chronic myeloid leukemia (CML) undergoing imatinib treatment who became infected with dengue virus. The patient presented with classic dengue symptoms, along with early minor bleeding (blood-stained sputum) during the first 5 days of illness. Continuous inpatient imatinib treatment for CML was given without blood transfusion. The hemoglobin and white blood-cell count slowly improved over 30 days while recovering from the dengue viral infection. The patient recovered from the dengue virus infection without complication. Clinical monitoring of hematologic changes is needed in dengue patients undergoing anticancer treatment.
The Southeast Asian journal of tropical medicine and public health 07/2012; 43(4):900-3. · 0.60 Impact Factor
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ABSTRACT: Hemorrhage is an important complication in dengue infection, but early predictors of clinically significant bleeding are undefined. This study aimed to determine clinical factors on admission associated with Type I bleeding, defined as gastrointestinal bleed, hematuria and menorrhagia, among adult patients with dengue infection. We carried out a retrospective study among 277 patients aged >15 years with serologically-confirmed dengue infection admitted to the Hospital for Tropical Diseases, Bangkok, Thailand during 2006-2009. Female gender (p<0.001), vomiting (p=0.05), severe thrombocytopenia (platelet count < 25 x 10(9)/l; p=0.007), high absolute lymphocyte count (ALC >500; p=0.05) and high aspartate aminotransferase level (AST >200; p=0.02) were significantly associated with hemorrhage on univariate analysis. Multivariate analysis revealed variables associated with bleeding were female gender [odds ratio (OR) 14.5; 95% confidence interval (CI) 0.16-0.56, p<0.001], thrombocytopenia (OR 4.7; 95%CI 0.13-0.9, p=0.03) and ALC >500 (OR 5.7; 95%CI 1.17-4.99, p=0.02). These data identify patients at high risk for developing clinically significant bleeding with dengue infection.
The Southeast Asian journal of tropical medicine and public health 07/2012; 43(4):890-9. · 0.60 Impact Factor
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ABSTRACT: Cerebral venous sinus thrombosis has been reported to be associated with various systemic illnesses and infections, including severe malaria. We report here a 43 year-old Thai male presenting with fever and seizures. He was diagnosed as and treated for severe falciparum malaria. After gaining consciousness he developed focal neurological signs and evidence of increased intracranial pressure. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) of the brain revealed a mid-superior sagittal sinus thrombosis with venous infarction. Investigations for other infections and thrombophilia were negative. The patient denied anticoagulant treatment. The clinical status and radiologic findings improved gradually. Physicians who care for malaria patients need to be aware of this rare complication when a malaria patient presents with focal neurological signs.
The Southeast Asian journal of tropical medicine and public health 09/2009; 40(5):893-7. · 0.60 Impact Factor
