Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013911 (emaciation)
 1,059 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case of a 25-year-old male agricultural laborer with HIV infection and Pneumocystis carinii pneumonia (PCP) is described, whose radiological lesions simulated pulmonary tuberculosis. He presented with loss of weight and appetite of 6 months' duration, cough with expectoration and minimal hemoptysis for 2 months, chest pain, diarrhea with fever, and odonophasia for 1 month. He had received antitubercular treatment (rifampicin 450 mg and isoniazid 300 mg) 2 months prior to admission. He had been promiscuous, having had multiple sexual contacts with prostitutes. General examination demonstrated marked emaciation, pallor, dyspnea, and oral candidiasis. Auscultation indicated fine medium pitched crackles in both infraclavicular regions. Blood for ELISA and immunocomb test were positive for HIV-1 antibodies. Hemogram revealed Hb 6 gm%, and TLC with polymorphs 63%, lymphocytes 30%, eosinophils 5%, and basophils 2%. The total lymphocyte count was 2100/cu. mm. Chest roentgenography revealed bilateral diffuse homogenous infiltrative lesions involving both lungs, with evidence of multiple bilateral cavitation. Therapy included antitubercular treatment with ethambutol, isoniazid, rifampicin, and pyrazinamide, along with Gentian violet mouth paint and ketoconazole orally, 200 mg bid. The patient developed progressive respiratory distress and died on the 7th day after admission. Limited autopsy of both lungs showed foamy eosinophilic material filling the alveolar space, and Grocett's methenamine silver staining showed cyst walls of P. carinii as black. There was no evidence of pulmonary tuberculosis. In the present case, the diagnosis of PCP should have been kept in mind to increase median survival time (25.9 vs. 12.6 months without treatment) with the treatment of choice of trimethoprim plus sulphamethoxizole in doses of 20 and 100 mg/kg/day. Early diagnosis and treatment will improve the mean survival time in cases of PCP with HIV infection.
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PMID:Pneumocystis carinii pneumonia simulating as pulmonary tuberculosis in AIDS. 901 80

Although pneumothorax is a well-known complication of AIDS related Pneumocystis carinii pneumonia, simultaneous bilateral pneumothorax has not been reported in Japan. A 54-year-old homeless man was admitted with emaciation and dyspnea. Chest X-ray showed diffuse ground glass opacity. Computed tomography of the chest demonstrated ground glass opacity and cyst-like lesions in both upper lobes of the lung. The patient was HIV positive. Grocott's stain of a bronchial lavage specimen demonstrated Pneumocystis carinii microorganisms. Intravenous trimethoprim-sulfamethoxazol and steroid administration was started. Seven days later, the patient developed tension pneumothorax of the right lung. Immediately after the thoracostomy, contralateral pneumothorax developed. Another chest tube was inserted. Subsequently, the patient died from bilateral pneumothorax. The endemicity of HIV infections among the homeless population is already a significant problem in Western countries. We should be aware that HIV infection may become a problem among the Japanese homeless as well.
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PMID:[Simultaneous bilateral pneumothorax complicating Pneumocystis carinii pneumonia in a homeless man with AIDS]. 1168 Oct 27