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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine of 122 patients dead from AIDS in central London presented with neurological disease, confirmed pathologically in seven. Seven had no other major systemic manifestations. AIDS needs to be considered in the differential diagnosis of meningitis, dementia, diffuse and focal encephalopathies, brainstem syndromes, myelopathy, visual failure and peripheral nerve syndromes. As AIDS becomes more widespread there will be an increasing need for diagnostic HIV testing in many neurological syndromes.
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PMID:Neurological presentations of AIDS--when to test for HIV. 261 62

This study is based on the analysis of 44 cerebrospinal fluid (CSF) samples from 11 patients with central nervous system (CNS) Candida infection. Risk factors for CNS fungal infection were present in all patients. Five had a chronic meningitis syndrome; two had acquired immunodeficiency syndrome (AIDS); two had cranial trauma followed by chronic meningities; one had intravascular disseminated coagulation syndrome and sepsis; and one had systemic candidiasis after kidney transplant. Etiological diagnosis was made in all by the CSF examination. Nine cases had positive CSF culture for Candida. Two patients presented the yeast in the direct examination, and one of them had reagent complement fixation test for Candida in three successive samples of CSF. Changes found in the CSF composition are discussed in order to evaluate the inflammatory response to CNS infection by Candida.
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PMID:[Cerebrospinal fluid in infection of the central nervous system by yeasts of the genus Candida: analysis of 11 cases]. 261 11

The acquired immunodeficiency syndrome (AIDS) is caused by human immunodeficiency virus (HIV) and characterized by disorders of the nervous system in addition to opportunistic infection and cancer. Centers for Disease Control (CDC) recommend the classification system consisting of four major groups. Group I is patients with acute HIV infection, and Group II is asymptomatic carriers. Group III is those with persistent generalized lymphadenopathy (PGL). Group IV includes five subgroups: IVA with constitutional disease, IVB with neurologic disease, IVC with secondary infectious diseases, IVD with secondary cancers and IVE with other conditions. The nervous system disorders are classified into two types: one is produced by HIV itself and not directly related to immunodeficiency, and the other caused by opportunistic infectious agents and cancers. The former is further divided into two kinds: atypical aseptic meningitis and acute inflammatory demyelinating polyneuropathy (AIDP) occur mainly in Group I and II, whereas HIV encephalopathy, distal symmetric polyneuropathy (DSPN) and vacuolar myelopathy in Group III and IV. Group I or II patients have no apparent medical problems. Therefore, when neurologists see patients with risk factors for HIV infection presenting with atypical meningitis or AIDP, it is of utmost importance to have a high index of suspicion and to look for evidence of HIV infection.
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PMID:[Disorders of the nervous system associated with the acquired immunodeficiency syndrome (AIDS)-clinical approach]. 263 Jan 48

About 120,000 infants are born each year with sickle cell disease (SCD) in Africa. The majority have Hb SS, but Hb SC and Hb S/beta+ thalassaemia are common in west Africa. The development of Plasmodium falciparum and P. malariae is partially inhibited in the Hb SS red cells, but malaria precipitates both haemolytic and infarctive crises, and is the commonest and most important cause of morbidity and mortality. The pneumococcus is likely to be the second major infectious cause of sickness and death. In one rural community, there were less than 2% of the expected number of subjects with SCD surviving beyond 5 years of age. Genetic factors improving prognosis include (1) the Senegal beta chain haplotype, which is linked to a high level of Hb F, and (2) alpha+ thalassaemia. Of environmental factors improving prognosis, the family is of first importance. The commonest age of presentation is 1-3 years. Children present with anaemic crises (malaria, splenic sequestration, folate deficiency, and possibly aplastic), infarctive crises (hand-foot syndrome, bone-pain, pulmonary and abdominal) or acute infections (malaria, pneumonia, septicaemia, meningitis, osteomyelitis). Tragically, many patients in central Africa have been infected by the human immunodeficiency virus (HIV) through blood transfusions; they present with generalised lymphadenopathy and other features of the acquired immunodeficiency syndrome (AIDS). The principles of management are (1) to ensure freedom from malaria, (2) to continue folic acid supplements, (3) to give blood transfusions only when anaemia endangers life, (4) to control pain, (5) to restore hydration, and (6) to prescribe broad spectrum antibiotics in large dosage and without delay, but only when there are definite indications, such as fever (greater than 39 degrees C), acute pulmonary disease, meningitis, and acute osteomyelitis. The advent of HIV and AIDS makes the control of SCD of even greater importance. Principles of control are (1) early diagnosis through appropriate laboratory techniques and selective screening, (2) education of parents, patients, health professionals and public, and (3) the maintenance of health at sickle cell clinics; measures must include antimalarial prophylaxis. SCD programmes should be integrated with primary health care and AIDS control programmes.
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PMID:The presentation, management and prevention of crisis in sickle cell disease in Africa. 265 Jul 73

Fungal and mycobacterial infections are among the most common opportunistic infections in patients infected with human immunodeficiency virus (HIV). Candida infections are the bell-wether of progression to symptomatic HIV infection and candida oesophagitis often marks the onset of the acquired immunodeficiency syndrome (AIDS). More than 80% of AIDS patients have candida disease. Candida infections remain local and respond to treatment but tend to recur. Cryptococcal infections initially affect few HIV positive patients but involve 10-30% with AIDS. Meningitis is the usual presentation and dissemination is common. Amphotericin usually produces improvement but cure is infrequent, and maintenance therapy is advisable. Mycobacteria cause intracellular infections increasing in parallel with immunodeficiency. Mycobacterium avium-intracellulare is predominant, occurring with other opportunistic pathogens causing systemic and local symptoms with high bacterial density in infected cells. Multidrug treatment is best, but the results are disappointing. Tuberculosis is prevalent in certain groups of patients. It often presents with atypical clinical and pathological features. Anti-tuberculous treatment is effective and prophylaxis should be considered. Endemic fungi with mycobacteria cause sporadic infections. Opportunistic infections are the lethal arm of HIV infection. Diligent diagnosis and persistent treatment offer benefit to HIV-infected patients.
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PMID:Fungal and mycobacterial infections in patients infected with the human immunodeficiency virus. 265 13

The peripheral and central nervous systems are commonly affected in patients with acquired immunodeficiency syndrome (AIDS). Primary infection with human immunodeficiency virus (HIV) can cause an acute encephalitis, meningitis, or an acute polyneuropathy. Spinal cord involvement can result in a progressive spastic paraparesis. Many patients develop dementia which can be severely debilitating. Sensory neuropathies can also occur late in the course.
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PMID:The neurologic manifestations of primary HIV infection. 265 95

We reviewed the records of 106 patients with cryptococcal infections and the acquired immunodeficiency syndrome (AIDS) treated at San Francisco General Hospital. We examined four issues: the efficacy of treatment with amphotericin plus flucytosine as compared with amphotericin alone, the efficacy of suppressive therapy, the prognostic clinical characteristics, and the course of nonmeningeal cryptococcosis. In 48 of the 106 patients (45 percent), cryptococcosis was the first manifestation of AIDS. Among the 89 patients with cryptococcal meningitis confirmed by culture, survival did not differ significantly between those treated with amphotericin plus flucytosine (n = 49) and those treated with amphotericin alone (n = 40). Flucytosine had to be discontinued in over half the patients because of cytopenia. Long-term suppressive therapy with either ketoconazole or amphotericin was associated with improved survival, as compared with survival in the absence of suppressive therapy (median survival, greater than or equal to 238 vs. 141 days; P less than 0.004). The only clinical features independently associated with a shorter cumulative survival were hyponatremia and a positive culture for cryptococcus from an extrameningeal source. The 14 patients with nonmeningeal cryptococcosis had a median survival (187 days) and rate of relapse (20 percent) similar to those in the patients with meningitis (165 days and 17 percent, respectively). From this retrospective study of cryptococcal infections in patients with AIDS we conclude that the addition of flucytosine to amphotericin neither enhances survival nor prevents relapse, but long-term suppressive therapy appears to benefit these patients.
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PMID:Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome. 230 1

Drug delivery to the central nervous system (CNS) is of vital concern to the therapy for primary CNS disorders and the development of drug neurotoxicity. The factors influencing drug entry into the CSF include the status of the blood-brain barrier (BBB) and lipid solubility, molecular weight, pKa, protein binding, and removal of the drug from the CSF by an exit pump in the choroid plexus. The most important of these factors is the status of the complex BBB systems. The morphologic equivalent of the BBB and its specialized functions (e.g., transport of D-glucose, amino acids, and ions) are discussed in depth. Methods developed for increasing drug delivery to the CNS by circumvention and/or manipulation of the BBB have included direct injection into the CSF, administration of prodrugs or chemical delivery systems, or reversible "opening" of the BBB by hyperosmotic agents, pentylenetetrazole, etoposide, DMSO, or other agents. The relevance of these general principles to selected examples of CNS infections (i.e., gram-negative aerobic bacillary meningitis and subacute encephalopathy associated with AIDS) is emphasized.
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PMID:Drug delivery to the central nervous system: general principles and relevance to therapy for infections of the central nervous system. 269 Mar 2

Data concerning 292 neurologic complications of AIDS were supplied by ten Departments of Neurology of Spanish hospitals. The period of study was from june 1984 to june 1988. The most frequent complications were: Toxoplasmosis of the CNS (28%), subacute encephalopathy (17%), distal polyneuropathy (8%), tuberculous meningitis (7.5%) and cryptococcal infection of the CNS (6.5%). The most important risk factors for AIDS in this series were intravenous drug addiction (77%) and homosexuality in males (12%). The overall mortality among the reported complications was 54.7%. The main causes of mortality were toxoplasmosis (32% of the fatalities), subacute encephalopathy (19%), and progressive multifocal leukoencephalopathy (8%). These data are compared to those obtained from other European and American series.
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PMID:[Neurologic complications of AIDS. Panoramic view based on a multicenter hospital study]. 270 Feb 95

Tuberculosis is being described as a highly associated entity with the acquired immunodeficiency syndrome (AIDS) in countries or geographical areas where this entity is endemic, even becoming its first clinical manifestation. Two cases of prostatic abscess are presented in patients with anti-HIV antibodies, who are parenteral drug users. In one of them, his genitourinary tuberculous infection was the first sign of AIDS. In the other, a previous association with tuberculous meningitis was found. The evolution and pathogenicity of tuberculous genitourinary in AIDS patients is discussed.
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PMID:[Genito-urinary tuberculosis in acquired immunodeficiency syndrome]. 271 12


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