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

The clinical, laboratory, and radiographic findings in seven patients with acquired immunodeficiency syndrome (AIDS) and cryptococcal pulmonary infections were reviewed. The infection was most commonly seen on radiographs as lymphadenopathy, interstitial infiltrates, or both. Interstitial infiltrates were commonly nodular. Large nodules or alveolar infiltrates, the most common findings at presentation in both immunocompetent patients and immunocompromised patients without AIDS, were not present in our series. Isolated pleural effusion was seen as the only radiographic finding in one case. Meningitis was present in six of seven cases and was neurologically silent in five of six cases. Cryptococcal pneumonia in AIDS patients should prompt a search for neurologically silent cryptococcal meningitis.
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PMID:Cryptococcal pulmonary infection in patients with AIDS: radiographic appearance. 234 21

Two patients with acquired immune deficiency syndrome presented with headaches and fevers. A diagnosis of cryptococcal meningitis was made by lumbar puncture and elevated cryptococcal antigens. Complaints of decreased vision in both patients led to the diagnosis of optic disc edema and cryptococcal choroiditis with yellow-white choroidal infiltrates noted in both eyes of the two patients. Systemic treatment with amphotericin B and 5' flucytosine led to resolution of the choroidal infiltrates. Late visual acuity loss was believed to be secondary to optic atrophy.
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PMID:Cryptococcal choroiditis. 234 88

There is a growing demand for laboratory diagnosis of cryptococcal meningitis, which is partly due to the increasing incidence of AIDS in Thailand. Presently, latex cryptococcal agglutination test (LCAT) is the most sensitive and specific test for laboratory cryptococcal meningitis. However, the test is very expensive and not readily available. LCAT must be developed locally to meet the need in Thailand. Rabbit antibody to C. neoformans was raised and used to sensitize latex particles used in LCAT. The developed LCAT was compared with a reference LCAT. The locally made LCAT was almost identical to the reference LCAT in sensitivity and specificity. It was extensively compared with the culture and India ink examination, in 73 cerebrospinal fluid specimens from cryptococcal meningitis and 155 specimens from other diseases. LCAT was found specific and more sensitive than fungal culture and India ink examination. LCAT is now extensively used in Thailand and recommended by Thai experts for use in all general hospitals. It is a simple, sensitive, specific, rapid and inexpensive tool for both diagnosis, prognosis and follow-up of cryptococcal meningitis.
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PMID:Evaluation of latex cryptococcal agglutination test in cryptococcal meningitis. 234 21

The detailed pharmacokinetics of fluconazole in serum and cerebrospinal fluid (CSF) were studied in a patient with acquired immunodeficiency syndrome and cryptococcal meningitis, after an intravenous dose of 400 mg. Fluconazole exhibited a serum elimination half-life of 34.2 hours, distribution volume of 0.56 L/kg, and clearance of 0.19 ml/min/kg. Peak CSF concentration occurred at 4 hours after the dose. Overall penetration of fluconazole based on the ratio of areas under the curve of CSF to serum was 70%. The drug exhibited an excellent pharmacokinetic profile for treatment of central nervous system fungal infections.
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PMID:Pharmacokinetics of fluconazole in serum and cerebrospinal fluid in a patient with AIDS and cryptococcal meningitis. 238 77

A routine serum cryptococcal antigen screening of 450 human immunodeficiency virus (HIV)-positive/acquired immunodeficiency syndrome (AIDS) patients at the Cliniques Universitaires de Kinshasa, Zaire, revealed that cryptococcal antigen was present in the sera of 55 (12.2%) of them. Health professionals collected cerebrospinal fluid of 44 patients from the positive serum group. The fungus Cryptococcus neoformans was identified by direct microscopy and culture in 29 (66%) of them. 6.6% of the originally screened HIV-positive/AIDS patients, therefore, had cryptococcal meningitis which is an opportunistic infection in these individuals. Serum screening for cryptococcal antigens could improve the prognosis of cryptococcal meningitis in HIV-infected patients by introducing an appropriate antifungal treatment at an early stage.
AIDS 1989 Feb
PMID:The value of cryptococcal serum antigen screening among HIV-positive/AIDS patients in Kinshasa, Zaire. 249 22

Neurological disorders were studied in 18 patients diagnosed to have AIDS and their findings are analysed. Amongst the problems seen were toxoplasmosis (9), cryptococcal meningitis (5), tuberculous meningitis (1), AIDS dementia complex (3), peripheral neuropathy (2), vertebrobasilar stroke, and a possible AIDS myelopathy in one case each. Their findings are discussed, and literature on the neurological disorders in AIDS reviewed.
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PMID:Neurological disorders in AIDS: a study of 18 cases. 251 34

Cerebrospinal fluid (CSF) cytology, white blood cell (WBC) count and protein were evaluated in 32 human immunodeficiency virus (HIV)-infected patients with the acquired immune deficiency syndrome (AIDS) or an AIDS-related complex who manifested a variety of neurologic symptoms. Of 17 patients with AIDS-related encephalitis (ARE), 13 had hypocellular CSFs; elevated WBCs and pleocytosis were noted in 4, multinucleated giant cells in 2 and elevated CSF protein was found in 4 of 8 specimens tested. Three patients with central nervous system (CNS) toxoplasmosis had unremarkable CSF cytology findings, but all had elevated CSF proteins. In five patients with cryptococcal meningitis, cytologic examinations demonstrated organisms in four and elevated proteins in three. Of five patients with primary CNS lymphomas, one had cytology positive for large cell lymphoma; two showed suspicious cells and two manifested "atypical lymphocytes." Elevated CSF protein was present in four. Other conditions observed included progressive multifocal leukoencephalopathy, tubercular meningitis and cytomegaloviral (CMV) meningitis or encephalitis. Twenty-five percent of patients with ARE manifested pleocytosis with multinucleated giant cells; pleocytosis with CMV inclusions was noted in a CMV viral radiculitis. The CSF cytologic examination in HIV-infected patients with neurologic complications seems helpful in diagnosing cryptococcal meningitis and lymphoma, but less so for diagnosing toxoplasmosis.
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PMID:Cerebrospinal fluid manifestations of the neurologic complications of human immunodeficiency virus infection. 253 86

Clinical evaluation of fluconazole was performed on 12 cases of mycotic infections (7 cases of Candida esophagitis; one each case of cryptococcal meningitis with AIDS, Candida tropicalis fungemia and disseminated cryptococcosis in kidney transplant patient; 2 cases of Candida pneumonia). Satisfactory responses were obtained except 1 case of Candida pneumonia in which clinical efficacy could not be evaluated. Hiccup was noted in 1 case during the fluconazole treatment. No other adverse reaction was observed. When 150 mg and 200 mg of fluconazole were administered orally to a patient with hemodialysis (HD) after HD on separate occasions, concentrations of the drug in serum at 20 hours after ingestion were 5.9 micrograms/ml and 11.6 micrograms/ml, respectively, and in cerebrospinal fluid (CSF) were 3.5 micrograms/ml and 9.2 micrograms/ml, respectively. Two clinical benefits were obtained in our studies. First, it was possible to treat the AIDS-patient as an outpatient with Candida esophagitis using orally administered fluconazole. Second, it was possible to treat the case of cryptococcal meningitis, in which relapse often occurs, to complete the therapy when the cryptococcal antigen in serum and CSF diminished to an undetectable level and to maintain the therapy preventing relapse without severe adverse effects. Ongoing and future clinical trials will define the specific roles of fluconazole more clearly in the treatment of systemic mycosis.
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PMID:[Clinical evaluation of fluconazole]. 254 Mar 65

The ocular complications of acquired immune deficiency syndrome (AIDS) include: (1) a noninfectious microangiopathy, most often seen in the retina, consisting of cotton-wool spots with or without intraretinal hemorrhages and other microvascular abnormalities; (2) opportunistic ocular infections, primarily cytomegalovirus (CMV) retinitis; (3) conjunctival, eyelid, or orbital involvement by those neoplasms seen in patients with AIDS (i.e., Kaposi's sarcoma and lymphoma); and (4) neuro-ophthalmic lesions. In a series of 200 AIDS patients evaluated clinically, AIDS retinopathy was present in 66.5%. Sixty-four percent had cotton-wool spots, and 12% had intraretinal hemorrhages. Cytomegalovirus retinitis was diagnosed in 28% of AIDS patients. Neuro-ophthalmic lesions were found in 8% of all AIDS patients and were present in 33% of those patients with cryptococcal meningitis. Acquired immune deficiency syndrome retinopathy was present in 40% of 35 patients with the AIDS-related complex (ARC) and in 1.3% of 232 patients with asymptomatic human immunodeficiency virus (HIV) infection, evaluated photographically. These results suggest that the prevalence of AIDS retinopathy increases with increasing severity of HIV infection, and that CMV retinitis presents a significant vision-threatening problem in AIDS patients.
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PMID:Ocular manifestations of acquired immune deficiency syndrome. 254 83

Cryptococcal meningitis is increasing in frequency, in large part because of the advent of acquired immune deficiency syndrome. Using the murine cryptococcosis model, a new oral triazole, SCH39304, has been compared with two drugs in clinical use, fluconazole and amphotericin B. BALB/c mice (nu/nu and nu/+) were challenged intracerebrally or intranasally. Oral treatment was given daily with SCH39304 at doses of 1 to 60 mg/kg of body weight or fluconazole at doses of 1 or 5 mg/kg of body weight. Amphotericin B was given intraperitoneally three times weekly, at doses of 3 or 6 mg/kg. After intracerebral challenge, SCH39304 prolonged survival in doses as low as 1 mg/kg, a dose at which fluconazole was ineffective. At equal doses, SCH39304 consistently increased survival more than did fluconazole but not longer than did amphotericin B. SCH39304 significantly lowered colony counts in brains more than did fluconazole but no more than did amphotericin B. SCH39304 was also superior to fluconazole after intranasal challenge at equal doses. SCH39304 appears to be superior to fluconazole in mice when the drugs are given at equal doses. Clinical trials are warranted.
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PMID:Efficacy of SCH39304 in murine cryptococcosis. 255 3


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