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Query: UMLS:C0010200 (
cough
)
23,843
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 41-year-old man infected with
HIV
-1 developed fever up to 39.8 degrees C together with nonproductive
cough
and dyspnoea. Lactate dehydrogenase concentration rose from a level of 998 U/l to 6307 U/l. As pneumocystis carinii pneumonia was at first suspected he was treated with co-trimoxazole (1600 mg sulfamethoxazole and 320 mg trimethoprim, four times daily). But the symptoms did not abate. Bone-marrow puncture revealed numerous macrophages containing ovoid inclusions typical of Histoplasma capsulatum varietas capsulatum. The diagnosis of disseminated histoplasmosis was confirmed by culture and serologically by an increase in Histoplasma polysaccharide antigen. On treatment with amphotericin B (at first 10 mg, then 50 mg daily for 4 weeks) the symptoms regressed within a few days. After the concentrations of lactate dehydrogenase and Histoplasma antigen had become normal again, maintenance treatment was changed to itraconazole (200 mg twice daily), after a total amphotericin B dose of 1150 mg. The patient has remained free of recurrence.
...
PMID:[Disseminated histoplasmosis in AIDS]. 818 12
A 33-year-old,
HIV
-1 positive, white, homosexual man was hospitalized in May, 1991, because of fever,
cough
, skin eruptions, anorexia, and weight loss during the previous 2 months. In October, 1990, he had traveled in Sumatra. On examination he was ill, tachypneic, normotensive with a temperature of 39.1 degrees Celsius. The spleen was substantially enlarged. Laboratory investigations showed: ALAT 72 U/I (normal 23 U/1), LDH 508 U/1 (normal 275 U/1). A bronchoscopy with bronchoalveolar lavage revealed yeast cells. Gastroscopy showed an ulcer in the hypopharynx and an erosion in the stomach. Biopsies of this ulcer demonstrated the presence of Penicillium marneffei. Biopsies of the liver showed the same organism. The patient was treated with amphotericin B induction therapy (1 dd 0.5 mg/kg for 21 days, total dose of 730 mg) in combination with flucytosine (3 dd 2500 mg, total dose 142 g in 19 days). In the following 2 weeks the temperature became normal, and the dyspnea and the skin eruptions disappeared, except for the mollusca contagiosa. The spleen diminished by 50%. LDH and ALAT became normal. Oral maintenance therapy followed with fluconazole (the first 3 months 400 mg daily, followed by 200 mg a day). 24 months later, no recurrence had been observed. Case 2 was a 28-year-old,
HIV
-infected, homosexual man, born in Suriname, who was hospitalized in October, 1991, with prolonged fever, dyspnea, and a painful throat. In March, 1991, he had traveled in rural Thailand. AIDS was diagnosed on the basis of cerebral toxoplasmosis in August, 1991. A biopsy of the ulcer in the oropharynx showed an active aspecific inflammation and also P. marneffei. Treatment with amphotericin B intravenously (0.5 mg/kg, total dose 1052 mg in 32 days) was commenced. The lesions in the oral cavity and throat, the lymph nodes, and the shortness of breath disappeared within a few days. Ten months later he died from emaciation caused by cryptosporidiosis.
...
PMID:Disseminated Penicillium marneffei infection as an imported disease in HIV-1 infected patients. Description of two cases and a review of the literature. 820 1
A 38-year-old man,
HIV
-positive for 6 years, developed fever and
cough
with deterioration in his general state. Chest radiography demonstrated an infiltration in the left upper lobe and computed tomography showed a septated cavity. Three bronchioalveolar lavages over 4 weeks recovered Klebsiella, Candida, Pseudomonas and Staphylococcus in the lavage fluid. Acid-fast rods were not found in any of the microscopic preparations. His clinical condition and the radiological findings deteriorated despite appropriate antibiotic administration. A further cavity occurred in the right upper lobe and the inflammatory infiltrations extended further. Although no acid-fast organism had been demonstrated, tuberculostatic treatment was begun (daily 300 mg isoniazid, 600 mg rifampicin, 900 mg streptomycin, 2 g pyrazinamide). His general condition and the radiological findings rapidly improved. Four weeks after culturing the lavage fluid atypical Mycobacterium xenopi was isolated. This case illustrates the difficulty of diagnosing an atypical mycobacterial infection. It takes time and effort, but it is of great importance because up to 50% of patients with AIDS contract such infection. Early and appropriate treatment will significantly improve quality of life and life expectancy.
...
PMID:[Pneumonia due to a rare atypical Mycobacterium in AIDS]. 822 23
The radiographic presentation of Pneumocystis carinii pneumonia (PCP) was studied in 93 consecutive patients to determine the frequency of normal findings on chest roentgenograms and possible correlations with clinical or laboratory findings. The roentgenograms were reviewed by two radiologists in an independent, blinded way and judged with a score distinguishing between none, interstitial, and acinar infiltrates. Discordance mainly between absent versus interstitial and interstitial versus acinar infiltrates occurred in 23% of roentgenograms and was settled by consensus. The majority of patients presented with moderate-to-mild symptoms; the combination of dyspnea,
cough
, and fever was present in 53%. Lactate dehydrogenase (LDH) was elevated in 63%, hypoxemia (PaO2 < 75 mm Hg) was present in 57%. Findings on chest roentgenograms were normal in 39%, whereas 36% showed interstitial and 25% acinar infiltrates. These three radiographic groups represented an increasingly severe PCP, indicated by higher LDH levels and hypoxemia (both p < 0.05). In a multivariate logistic regression, normal roentgenograms were predicted by low LDH and low peripheral blood granulocytes (p < 0.005). Mortality within 3 weeks was only 4% and correlated with the severity of infiltrates (p < 0.05). Normal roentgenograms thus corresponded to an oligosymptomatic, less severe PCP. In immunodeficient
HIV
-infected patients, a normal chest roentgenogram does not exclude PCP and should not distract from attaining a definite diagnosis by examination of induced sputum or bronchoalveolar lavage.
...
PMID:Shortcomings of chest radiography in detecting Pneumocystis carinii pneumonia. 826 51
The difficulties of health education concerning AIDs prevention in Zimbabwe include communicating simple information about complicated processes, resistance to the information because of status or tradition, and lack of experience with translating material that was produced in the West. The beliefs in ghosts and witch doctors are still part of the tradition in Zimbabwe, providing cultural diversity and a sense of identification. Traditional medicine is characterized by Westerners as often irrational behavior that is deleterious to one's health. However, even in the allegedly educated part of the world compliance is often lacking and alternative treatment forms are actively pursued in tandem with formal medicine. When there is a short time period between harmful behavior and infection, most people realize that there is a causative connection. On the other hand, it is a more complicated mental exercise to fathom that intercourse can result in
HIV infection
that 5 years later may lead to death from tuberculosis. No other disease is known by these people that has a corresponding delay from the time of infection to disease or death. It is also confusing that a sexually transmitted disease does not produce symptoms such as discharge or genital sores. It is difficult to comprehend that a sole causative agent,
HIV
, can lead to so many different diseases and symptoms. When a young man died after having been hospitalized with protracted
cough
and TB as a result of
HIV infection
that he had contracted from a girlfriend, the father told the folks at home that his son had died of TB. These conflicting pieces of information make AIDS prevention education wrought with difficulties, which adds to the rapid spread of the disease, although the authorities and international organizations have responded with strategies, informational materials, and educational courses.
...
PMID:[AIDS information in Zimbabwe]. 827 86
A 25-year old
HIV
-1-positive hemophiliac was admitted with fever,
cough
, exertional dyspnea and pleuritic chest pain. Chest x-ray showed diffuse bilateral infiltrates with a left sided nodular consolidation. Pneumocystis-carinii-pneumonia was suspected and diagnosed by broncho-alveolar lavage. With therapy the diffuse infiltrates improved, but the nodule and the symptoms failed to resolve. A fine-needle aspiration of the nodule revealed concurrent cryptococcosis. Treatment with fluconazole resulted in complete resolution of symptoms. Details of the case are presented and clinical implications are discussed.
...
PMID:[Double infection of the lung with Pneumocystis carinii and Cryptococcus neoformans in an AIDS patient]. 830 25
Treatment with ethambutol 15 mg/kg, rifabutin 6 mg/kg and amikacin 15 mg/kg (IV for 2-4 weeks) in 31
HIV
infected patients with severe immunodeficiency and infection caused by Mycobacterium avium complex (MAC) was evaluated in a retrospective study. The patients had one or more of the following clinical features: fever 31, weight loss 13,
cough
10, pleurisy I, pericarditis 2, diarrhoea 12, peritonitis I. MAC was cultured from blood in 29, bone marrow in six, sputum in nine, faeces in 15, bowel biopsy in six and liver biopsy in four patients. Twenty-two of the 31 patients showed treatment response after a median time of 14 days, and five had a relapse successfully treated with another course of amikacin. Median survival time was 8 months.
...
PMID:Efficacy of triple drug regimen of amikacin, ethambutol and rifabutin in AIDS patients with symptomatic Mycobacterium avium complex infection. 838 30
We investigated the long-term health effects of
HIV
-1 infection in homosexual men not close to developing AIDS by comparing 916
HIV
-1-seropositive (SP) men at least 1.67-3.67 years prior to a clinical AIDS diagnosis to 2,161
HIV
-1-seronegative (SN) controls. The SP group reported a higher total of 12 distinct symptoms (fatigue, shortness of breath, night sweats, rash,
cough
, diarrhea, headache, thrush, skin discoloration, fever, weight loss, and sore throat/mouth) than did the SN group (p < 0.0001), corresponding to at least 5.6 more days/year of such symptoms. The SP group had lower body mass index (p < 0.0001) and lower hemoglobin (p < 0.0001). The SP group was more depressed, as measured by CES-D score (p = 0.047), before knowledge of one's serostatus was likely, and became even further depressed (p = 0.038 for increase in depression) after the
HIV
-1 serostatus test was accessible to high-risk groups. These associations remained unchanged in multivariate models, incorporating other covariates.
...
PMID:Signs and symptoms of "asymptomatic" HIV-1 infection in homosexual men. Multicenter AIDS Cohort Study. 826 59
A Haitian woman with the human immunodeficiency virus (HIV) presented with dyspnea,
cough
, fatigue and lower abdominal pain of recent onset. Clinical, radiologic and hemodynamic investigations demonstrated pulmonary hypertension. The patient died a few days later. The pathological findings were compatible with primary pulmonary hypertension. This case is similar to others that have been reported and indicates a possible link between
HIV infection
and rapidly progressive primary pulmonary hypertension.
...
PMID:Primary pulmonary hypertension associated with HIV infection. 842 54
Many adults are susceptible to pertussis, and Bordetella pertussis has been isolated from five patients with
HIV disease
. The prevalence of B. pertussis in 60
HIV
-infected adults with nasopharyngeal (NP) swab cultures were studied and questionnaires were used that assessed
HIV
-related risk behaviors and disease status, immunization history, and symptoms of respiratory disease. Although 72% had
cough
and 33% had
cough
for > 14 days, no nasopharyngeal (NP) swab cultures were positive for Bordetella species. Of the 44 (73%) patients who had follow-up NP swab cultures at 6 months, all were still negative. On the basis of these data from our
HIV
-infected population, the estimated population prevalence of pertussis is zero, with an upper 95% confidence limit of 0.00065, or fewer than 6.5 cases of pertussis per 10,000
HIV
-infected adults. Given this low prevalence,
HIV
-infected patients with respiratory symptoms do not appear to be a reservoir for B. pertussis in the community.
...
PMID:Pertussis is rare in human immunodeficiency virus disease. 843 Sep 67
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