Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In July 1990 in Zaire, a 36-year-old man was admitted to the University Clinic in Kinshasa for intense headaches, fever, vertigo, vision troubles, hallucinations, and irregular speech. He exhibited moderate wasting, left facial paralysis, and prurigo spots on the legs. Laboratory examinations revealed HIV seropositivity, antibodies to cryptococci, protein in the cerebrospinal fluid, and glucose in the cerebrospinal fluid. He was placed on 400 mg/d fluconazole. He died on August 4, two days after slipping into a coma. Cryptococcus neoformans var. gattii was isolated. The man had lived in a free union with two women. One died in 1989 of an illness characterized by persistent fever, considerable wasting, and pulmonary tuberculosis. The other woman is still alive although often having febrile episodes. She is HIV seropositive. Before AIDS arrived, cryptococcosis was rare in Zaire and Cryptococcus neoformans var. gattii was the most common etiologic agent. With AIDS, cryptococcosis has become an opportunistic infection. Since 1983, all cryptococcosis cases at the university clinics were a complication of AIDS. Cryptococcus neoformans var. neoformans was the etiologic agent in all these cases. It is possible that exposure to neoformans variety is more common than exposure to gattii variety. It is therefore an epidemiologic problem intimately associated with the geographic topography specific to ecological niches of these two varieties. Neoformans variety is found in pigeon droppings, while gattii variety has never been found in bird droppings. Gattii's natural host is the eucalyptus tree, found in Zaire. The case lived 400 m from a eucalyptus plantation. He was the only gattii variety cryptococcosis case in 1990-1991 among the 49 cryptococcosis cases at the Kinshasa University Clinics. In conclusion, gattii variety rarely causes cryptococcosis among AIDS patients because its natural reservoir is rare in urban areas where the AIDS epidemic is centered.
 ...
PMID:[Cryptococcosis caused by Cryptococcus neoformans var. Gattii. A case associated with acquired immunodeficiency syndrome (AIDS) in Kinshasa, Zaire]. 149 13

A 32-year-old homosexual man presented with headache and progressive right hemiparesis. CT scan revealed a heterogeneous ring-enhancing mass in the left parietooccipital lobe which proved to be astrocytoma. Clinicians should be aware of this new and unusual association of a cerebral glioma and acquired immune deficiency syndrome. Tissue examination is essential for proper diagnosis.
 ...
PMID:Acquired immunodeficiency syndrome associated with cerebral astrocytoma. 154 79

Neuro-cryptococcosis is a common opportunistic infection in AIDS or HIV infected patients. From a series of 10 neuro-cryptococcosis the four of them studied by magnetic resonance (MR) are reported. In AIDS patients a high suspicion of opportunistic infection of the CNS is needed as exemplified by two of the four patients who only presented cephalalgia. The other two patients suffered additional symptoms and signs of meningeal and CNS involvement, such as nuchal rigidity, cranial nerve palsies, papilloedema, gait ataxia and dismetria. Diagnosis was achieved (confirmed) by a positive culture, serology or indian ink test in CSF. CT scan did not contribute to the diagnosis and management of the patients. In contrast MR, showed in three of them a peculiar pattern of small, confluent, high-signal lesions, roughly symmetrically placed in the basal ganglia and the internal capsule. They probably correspond to the dilated Virchow-Robin spaces through which torulae migrate from the subarachnoid space.
 ...
PMID:[Use of magnetic resonance in the diagnosis of neuro-cryptococcosis in the acquired immunodeficiency syndrome: study of 4 patients]. 155 79

2 AIDS patients are described who had cryptococcal meningitis accompanied by increased intracranial pressure (ICP) and visual complications, a finding thought to be relatively rare in AIDS. Of the 2-6% of AIDS patients who develop cryptococcal meningitis, many have disseminated and recurrent infections. The 1st case was a 45-year old Ugandan woman who presented with stiff neck, and right VIth cranial nerve palsy. She was treated with amphotericin B and flucytosine with some improvement, but on the 9th day she awoke with headache, drowsiness, and total blindness, although no papilledema. Her CSF pressure was 40 cm H20. She recovered after a month of intravenous chemotherapy and acetazolamide, but remained blind. Her sudden blindness was thought to be due to bilateral optic nerve infarction. The 2nd case was a 32-year old male homosexual, admitted with headache, vomiting, confusion, and drowsiness. He had stiff neck, and a CSF of 40 cm containing Cryptococcus neoformans. He was given amphotericin B, flucytosine, and has CSF drained every other day. On day 21 papilledema was seen in the right eye, and acetazolamide was started to lower CSF pressure. This patient recovered without loss of vision. 3 published series of cryptococcus meningitis in AIDS patients remarked about the low incidence of raised ICP, while 1 reported 9 of 27 with neurological and ophthalmic complications. The visual complications and increased ICP in these patients was thought to be due to inflammatory arachnoiditis or direct cryptococcal infiltration.
 ...
PMID:Raised intracranial pressure and visual complications in AIDS patients with cryptococcal meningitis. 156 10

A retrospective analysis of 41 patients with cryptococcal meningitis and AIDS or neoplastic disease was done. Patients with AIDS were younger and predominantly male; they had a shorter duration of prior illness, higher initial serum cryptococcal antigen titers, and lower initial cerebrospinal fluid white blood cell counts than those with neoplastic disease. The median overall survival for patients with AIDS was 9 months compared with 2 months for those with neoplastic disease (P = .004). Seventy-eight percent of patients with AIDS and 43% of those with neoplastic disease were cured or improved 6 months after diagnosis (P = .039). Toxicity from amphotericin B and flucytosine was similar for both groups. One patient with AIDS relapsed. Multivariate predictors of survival included headache (P = .007) and an AIDS diagnosis (P = .009). Examination of outcomes for other opportunistic infections associated with AIDS and other immunosuppressive illness may distinguish prognostic features for different patient populations.
 ...
PMID:Cryptococcal meningitis: outcome in patients with AIDS and patients with neoplastic disease. 156 50

Neurosyphilis, a sexually transmitted disease that can cause neurologic damage, has become increasingly prevalent in the AIDS era. HIV carriers can contract neurosyphilis without the presence of other concurrent opportunistic infections. Because MR findings of neurosyphilis are seldom reported, we retrospectively reviewed and evaluated contrast-enhanced MR images of six young (average age, 33 years) HIV-positive men with high serum and CSF VDRL titers indicative of neurosyphilis. All six patients tested negative for concurrent opportunistic infections. Five patients had acute or subacute strokelike symptoms involving the basal ganglia or middle cerebral arteries; one had a parietal convexity mass mimicking meningioma with headache and ataxia. Contrast-enhanced MR images showed patchy enhancement involving the basal ganglia and middle cerebral artery territories in the first five patients and the convexity mass in the sixth patient. On the basis of brain biopsy, a convexity mass was diagnosed in the patient with syphilitic gumma. The imaging findings of the remaining five patients represented ischemic infarct caused by meningovascular syphilis. After penicillin treatment, serum and CSF VDRL titers decreased, and neurologic signs and symptoms improved in all six patients. A follow-up MR study in the patient with the gumma showed that the lesion resolved almost completely. In young HIV patients with stroke symptoms or a convexity mass, neurosyphilis should be considered. Contrast-enhanced MR can reveal the extent of involvement by neurosyphilis and should be used to facilitate diagnosis and proper treatment.
 ...
PMID:Neurosyphilis in HIV carriers: MR findings in six patients. 159 Jan 35

Cryptococcus neoformans is an important opportunist pathogen in human immunodeficiency virus (HIV) infection. Cryptococcal meningitis (CM) 3rd after primary HIV neuropathy an Toxoplasma gondii among infectious neurological diseases in AIDS patients. Extrapulmonary infection due to C. neoformans has occurred in up to 13% of patients. 86% of the Cryptococcus spp isolates in the US, Canada, and Japan are serotype A. Thousands of infection due to var neoformans have been reported in AIDS patients but only 3 cases of var gattii. Cryptococcal pneumonia meningitis appears in 63-84% of AIDS patients with symptoms of fever, headache, meningism, and photophobia. 17-37% of AIDS patients with Cm die during therapy, and only 18-30% live over 12 months. Treatment in patients without immunodeficiency deficit is with a combination of .3 mg/kg/day of amphotericin B and 150 mg/kg/day of flucytosine for 4 weeks. A dose of .5-.8 mg/kg/day amphotericin was most effective although renal toxicity occurred in 80% of patients. Fluconazole has been used since 1987: cerebrospinal fluid concentrations reached 60-80% in serum. Treatment in 8 of 14 patients receiving 400 mg/day fluconazole failed while it did not in 6 patients treated with .7 mg/kg/day of amphotericin for 7 days and flucytosine 100 mg/kg/day. 200 mg/bid itraconazole was given to 32 patients with cryptococcosis (24 CM cases and 26 AIDS victims) and 65% of CM patients improved clinically with negative cultures. The relapse of 2 of 106 patients taking 200 mg/day fluconazole and 13 of 77 patients taking 1 mg/kg/week amphotericin B occurred in maintenance therapy. CM was suppressed in 10 of 15 patients with 400 mg/kg itrazonazole. Prophylactic use of azole drugs in AIDS does not protect completely from CM although it reduced systemic fungal infections such as cryptococcosis.
Int J STD AIDS
PMID:Cryptococcal infection in AIDS. 161 62

We have studied 10 patients with cryptococcal meningitis and AIDS. Nine of them were intravenous drug users and four have been previously diagnosed of AIDS. In 60% of them cryptococcal meningitis was the first opportunistic infection, and as group represented only 6.3% of our 158 patients with AIDS on the same period. The most common symptoms were: malaise (100%), headache (80%), fever (60%), meningeal signs (50%). Two of them had focal neurological disease. CSF culture and serum cryptococcal antigen test were positive in 90%, the Indian ink in 77% and blood cultures in 30% of the cases, while indian ink preparation did it in 77%. MRI showed bilateral small lesions, deeply located, in 3 cases; it was also useful to prove optical tract lesions in a patient with blindness as a result of cryptococcal meningitis. We had treatment successes in 80% of the cases, all patients being treated with amphotericin B, alone in 4 and amphotericin B plus fluorocytosine in 6. Two patients died within the first 2 weeks. Maintenance therapy with fluconazole was effective and well tolerated, with 3 patients dying from causes other than cryptococcal meningitis. We recorded a survival rate over 12 months in 33% of patients.
 ...
PMID:[Cryptococcal meningitis and AIDS. Clinical description of 10 patients]. 164 45

In this paper is reported the first case of acquired immunodeficiency syndrome (AIDS) in the Chinese continent. In the initial stage, the patient (male) experienced fever, malaise and headache in April, 1990, and then developed repeated pulmonary infection and insidious progressive subacute encephalitis. The diagnosis of AIDS was confirmed by serological test for positive HIV antibody by enzyme linked immunosorbent assays(ELISA), immunofluorescence assays (IFA) and Western blot test(WB), significant reducing of CD4 lymphocyte, reverse of CD4/CD8 ratio and isolation of HIV-1 from peripheral blood in August, 1990. The patient died on September 2nd, 1990. In autopsy, there were generalized atrophy of lymph tissues, lymphocytic depletion, diffusive inflammation and necroses of the cerebral and cerebella parenchyma caused by toxoplasma, multifocal Kaposi's sarcoma of the stomach, and small intestine and bronchopneumonia.
 ...
PMID:[First reported case of AIDS in China]. 166 68

Acute sinusitis in adults is manifested by fever, facial pain and purulent rhinorrhea, but children--who rarely have headache or facial tenderness--have persistent cough in addition to fever and purulent rhinorrhea. Sinus transillumination is diagnostically useful only in adults. In children, maxillary sinus radiographs are indicated. New studies show ultrasound examination to be less sensitive than plain radiographs. Cultures obtained by aspiration of the maxillary sinuses are useful in complicated cases. Amoxicillin is still effective as first-line treatment, but treatment failure requires a prompt change to trimethoprim-sulfamethoxazole or ciprofloxacin. Nosocomial sinusitis requires coverage for gram-negative bacteria, including Pseudomonas aeruginosa. Immunocompromised patients, including those with acquired immunodeficiency syndrome, require treatment for fungal organisms. Decongestants are of unproven value. Referral for irrigation and surgical drainage is indicated for recurrent or recalcitrant sinusitis. Flexible endoscopy allows visualization and debridement of diseased tissue in cases of chronic sinusitis.
 ...
PMID:Acute sinusitis: diagnosis and treatment update. 146 11


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>