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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Viral and bacterial infections in 20 children under 3 years of age were studied in a day centre for 12 weeks. Febrile illnesses were found on one occasion in each of 11 children but no serious infection occurred. Pneumococci types 6, 9, or 19 were isolated from all children but more often from those with rhinitis or cough. The individual child had an average of 2 viral infections. Adenovirus types 1, 2, 5, coxsackievirus type B5, herpes simplex virus or respiratory syncytial virus was isolated from 12% of the oropharynx swabs and 40% of the fecal specimens. When a virus was first isolated from the oropharynx, the children were asymptomatic or had only rhinitis in 73% of the cases which might indicate that the dismissing of symptomatic children is of limited value in controlling the spread of infections in a day care centre. Cytomegalovirus was recovered from 22% of the urine specimens. Carrier frequency of cytomegalovirus was 23% in 40 other children attending one of 13 different day care centers. Because asymptomatic cytomegalovirus infections apparently occur frequently among small children in Sweden, it seems reasonable not to take pronounced measures of isolating the children in the relatively few recognized cases of cytomegalovirus infections.
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PMID:Infections in preschool children in group day care. 77 98

We performed a 5-year review of 40 patients less than or equal to 30 days of age with viral pneumonia. Isolates included respiratory syncytial virus (55%), enteroviruses (15%), rhinoviruses (15%), adenoviruses (10%), parainfluenza virus (7.5%) and herpes simplex virus (5%). Most infants were previously healthy but had ill family members. Nine were born at less than 37 weeks of gestation. Symptoms and signs included tachypnea, decreased feeding, cough, cyanosis, lethargy, retractions, apnea, bradycardia, seizures and depressed consciousness. Seasonality and clinical features, but not radiographic patterns, suggested specific pathogens. Patients were moderately to severely ill. The median duration of hospitalization was 7 days; therapies administered included oxygen (90%), mechanical ventilation (45%), blood transfusions (25%) and supplemental oxygen after discharge (27%). The case fatality rate was 7.5%. Prematurity, ill appearance at presentation, lobar consolidation and adenovirus infection were risk factors for severe disease.
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PMID:Viral pneumonia in the first month of life. 217 40

A 10-year-old boy had gait and speech disturbances 17 days after the initial symptoms of a fever, headache and cough. Four days later he was admitted to a hospital with mild disturbances of gait, speech, writing, visual acuity, left facial nerve, nystagmus and consciousness. Impairments of cranial nerves (II, III and VII), pyramidal sign and cerebellar sign were noticed. EEG showed generalized slow waves. Auditory brain stem response showed prolongation of the interval between I and V waves and poor differentiation between them. Brain CT could not find any abnormalities. Brain stem encephalitis was diagnosed. Clinical signs and symptoms continued for two weeks when steroid therapy was started and it was effective to improve the disease. He was discharged from the hospital without sequelae. Herpes simplex virus (HSV) type 1 was detected from cells in CSF on admission by fluorescence antibody method. HSV antibody titers in sera changed from 1/8 to 1/64 during three months by complement fixation test. Specific IgG and IgA by enzyme linked immunosorbent assay (ELISA) was high in CSF. Specific antibody in CSF/total antibody in CSF: specific antibody in serum/total antibody in serum for IgG and IgA classes were more than 1. Reports of mild type of HSV brain stem encephalitis seemed to be rare. Our case which was followed for several months carefully would be important to discuss.
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PMID:[A mild form of brain stem encephalitis due to herpes simplex virus]. 301 73

Diagnosis of clinical AIDS can be difficult for clinicians in Africa, where there is only limited access to the sophisticated bacteriological diagnostic facilities needed for diagnoses based on the criteria laid down by the Center for Disease Control in the US. The most common presentation of AIDS in Africa is as an enteropathic condition known as 'Slim.' Based on this and other common presentations of the disease in Africa, a group of clinicians in Bangui, Central African Republic, drew up a list of criteria for the diagnosis of AIDS in Africa which are based on patient history and examination and the exclusion of other conditions rather than on serological confirmation of HIV infection. The major criteria are 1) unexplained fever for longer than 1 month; 2) unexplained diarrhea for longer than 1 month; and 3) weight loss greater than 10% of previous weight. Minor symptoms are presence of a maculopapular rash, oral candidiasis or thrush, herpes zoster or shingles, aggressive or uncontrollable herpes simplex, unexplained cough for longer than 1 month, or enlarged lymph nodes in more than 1 extrainguinal site. The finding of 2 major symptoms and at least 1 minor one is enough for diagnosis. These criteria have been found to be useful. However, they do not cover all the presentations which have been associated with AIDS. Unusual presentations of HIV infected persons which have been seen in Africa include serially developing abscesses in pyomyositis, gall bladder diseases, pericarditis or myocarditis, diseases of the Central Nervous System (cryptococcal meningitis, toxoplasmosis, non-specific leuko-encephalitis, atraumatic paraplegia, acute psychosis or chronic deterioration in mental capacity, lymphoma of the brain), prodromal illnesses, swollen lymph nodes, herpes zoster or shingles in young adults, or tumours of the lymphatic system. Differential diagnosis is extremely important.
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PMID:Clinical manifestations of AIDS in tropical countries. 319 42

Acquired immunodeficiency syndrome (AIDS) is reviewed for dental practitioners, with an emphasis on oral findings; the clinical course, diagnosis, reporting, treatment, prognosis, transmission, and epidemiology are also covered. HIV infection has an incubation period that may be associated with glandular fever, a prodrome called AIDS-Related Complex (ARC) characterized by lymphadenopathy, low fever, weight loss, night sweats, diarrhea, oral candidosis, nonproductive cough and recurrent infections. AIDS is characterized by opportunistic infections. Over 50% present with pneumocystis carinii pneumonia, 21% with Kaposi's sarcoma, and 6% have both. The AIDS virus causes direct neurological symptoms in some cases. Oral candidosis (thrush) in a young male without a local cause such as xerostomia or immune suppression is strongly suggestive of AIDS. Other oral manifestations are severe herpes simplex, varicella-zoster, Epstein-Barr virus, cytomegalovirus, venereal warts, aphthous ulceration, mycobacterial oral ulcers, oral histoplasmosis, sinusitis and osteomyelitis of the jaw. Hairy leukoplakia, usually seen on the lateral border of the tongue, is probably caused by Epstein-Barr virus. Kaposi's sarcoma, an endothelial cell tumor, is characteristic of AIDS, and in 50% of patients is oral or perioral. Cervical lymph node enlargement will be seen in those with ARC as well as AIDS. No guidelines have been issued by the Department of Health and Social Security for dental surgeons in the UK for reporting AIDS cases. Although HIV virions have been isolated from saliva, there are no known incidents of transmission via saliva. HIV is less likely to be transmitted by needle stick injuries than, for example hepatitis B (25% risk), especially if the blood is from a carrier rather than a full blown AIDS case.
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PMID:Acquired immune deficiency syndrome: review. 352 29

Fourteen previously healthy young patients with unusual community-acquired opportunistic infections were seen over a period of three years. They differ from patients previously described in that 11 were heterosexual drug abusers (including two women) and only three were homosexual men. There were eight Puerto Ricans, five blacks, and one white. Infections included Pneumocystis carinii pneumonia (seven), disseminated Mycobacterium intracellulare infection, histoplasmosis, cryptococcosis, and cytomegalovirus infection (one each), oral thrush (13), and Candida esophagitis (two). All patients had impaired cellular immunity manifested by cutaneous anergy and lymphopenia, and all 11 tested had a markedly decreased ratio of T helper/inducer cells to T suppressor/cytotoxic cells. Twelve had evidence of associated viral infection (Epstein-Barr virus in nine, cytomegalovirus in five, Herpes simplex type 2 in two). Clinical presentation was with a severe opportunistic infection or with a prodrome consisting of oral thrush and nonspecific findings including malaise, fever, lymphadenopathy, or cough. The syndrome of immunodeficiency and opportunistic infection occurs in nonwhite heterosexual drug abusers, not exclusively in white homosexual men, and patients may present for medical care before the onset of a severe opportunistic infection.
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PMID:Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men. 621 79

Acute superior laryngeal palsy is often clinically unrecognized and frequently overlooked. Yet, this motor paralysis occurs more frequently than facial paralysis. Like acute facial paralysis, superior laryngeal palsy often occurs as part of a cranial polyneuritis that is probably related to herpes simplex virus reactivation. Rotation of the larynx and shortening of one vocal cord have been found in such diverse syndromes as vestibular neuronitis, migraine and tension headaches, unexplained cough, tinnitus aurium, globus hystericus, and carotidynia. Electromyographic studies suggest that laryngeal spasm may be caused by faulty regeneration of the superior, rather than the recurrent, laryngeal nerve.
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PMID:Acute superior laryngeal nerve palsy: analysis of 78 cases. 682 26

In June 1993, in Taiwan, a woman admitted to a local hospital with cough, fever, chills, and difficult breathing who tested positive for HIV-1 infection was transferred to Taipei Veterans General Hospital. In January 1985, at a provincial hospital, then 46 years old, she underwent an anterior total hysterectomy and bilateral salpingo-oophorectomy during which she received two units of whole blood. One of the blood donors was an AIDS patient who had been treated at the same hospital in 1991 and who had died in 1993. In the interim between hospitalizations, she had two episodes of herpes zoster infection, including oral ulcers diagnosed as herpetic gingivostomatitis, and an episode of oral candidiasis. Physicians at the Taipei Veterans General Hospital diagnosed oral candidiasis, herpes simplex type 1 virus infection forming ulcers on her lips, and Pneumocystis carinii pneumonia in June 1993. Her CD4 count was 0 and her CD8 count was 20%. Treatment consisted of intravenous (IV) trimethoprim/sulfamethoxazole (TMP/SMX) and oral zidovudine, fluconazole, and acyclovir. She continued this medication after discharge in August 1993. She was readmitted to Taipei Veterans General Hospital in February 1994 for blurred vision. She was diagnosed with cytomegalovirus retinitis. Her CD4 count was up to 1% and her CD8 count was down to 8%. The candidiasis infection had extended from her oral cavity to the esophageal mucosa. She was put on IV ganciclovir, TMP/SMX, and fluconazole. She was discharged 3 weeks after admission. Her condition deteriorated thereafter, resulting in her death in August 1994. Up until this study, this HIV/AIDS case was listed with 79 other HIV/AIDS patients as unknown cause. During the 8 years between HIV exposure and her diagnosis of AIDS, she had unprotected sexual intercourse with her husband. Neither the husband nor any of her four children have AIDS. Screening for HIV-1 in Taiwan began in January 1988. The authors urgently recommend that anyone who received a blood transfusion between 1984 and 1987 in Taiwan and who currently suffers repeated episodes of opportunistic infections undergo an HIV-1 blood test.
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PMID:Transfusion-acquired AIDS in Taiwan. 864 96

In Zimbabwe, researchers analyzed data on blood samples collected from 627 adult patients at least 14 years old at all hospitals in the 7 districts of Masvingo Province during June 1990-December 1992 to reexamine the criteria for diagnosis of HIV infection in hopes of improving the Zimbabwe Adult AIDS case definition. This case definition is: an illness characterized by at least 2 major signs and 1 minor sign provided serologic tests for HIV are positive (major signs: weight loss 10% of body weight, chronic diarrhea for 1 month, and fever for 1 month; minor signs: cough 1 month, general pruritic dermatitis, recurrent Herpes zoster, oropharyngeal candidates, chronic progressive and disseminated Herpes simplex infection, and generalized lymphadenopathy). 79.1% tested positive for HIV infection. 271 of all adult patients had signs and symptoms that met the criterion for diagnosis of HIV infection. 97.1% of them actually had HIV infection. The specificity for this criterion was 93.9%, but its sensitivity was 53%, suggesting a high ability of clinicians to identify HIV positive patients but low ability to correctly exclude HIV infection. The positive predictive value was higher than that in Uganda (97% vs. 74%). The symptom with the highest positive predictive value and the highest sensitivity value was weight loss greater than 10% of body weight (98.9% vs. 2-71.9% and 74.6% vs. 1.5-57.4%, respectively). Candidiasis and chronic diarrhea had the highest specificity values (86.3% and 85.4%, respectively, vs. 26.4-80.9%). In conclusion, the criterion for diagnosis of HIV infection in Zimbabwe is very specific but rather insensitive at identifying HIV positive patients.
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PMID:Retrospective study on the criteria for diagnosis of HIV infection in adults in Zimbabwe. 877 33

Croup is an acute infectious illness usually occurring in children; it is characterized by brassy cough and stridor. The main pathogens include mainly parainfluenza and influenza viruses. Recently there have been reports of prolonged croup caused by the herpes simplex viruses. We report two cases of prolonged croup due to herpes simplex types 1 and 2. We also review and summarize the reported pediatric cases of herpetic croup.
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PMID:Herpetic croup: two case reports and a review of the literature. 883 94


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