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Query: UMLS:C0018681 (headache)
56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The HIV epidemic probably arose in Africa at about the same time as in the West, and there is a significant seroprevalence of HIV in the central African region. However, the epidemiology and clinical course of AIDS are different in Africa and in the West. In Africa males are infected as often as females, and the commonest means of transmission is heterosexual intercourse. Many HIV-infected people are symptomless, but many others present with or progress to generalized lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral candidiasis. The World Health Organization developed a clinical case-definition of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients is more aggressive than that seen in the West and is often visceral. Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological manifestations include cerebral toxoplasmosis, cytomegalovirus infection, headache, and terminal encephalopathy. About 60% of infants born to seropositive women are infected and die within the 1st year of life. Lack of drugs and diagnostic facilities make both diagnosis and treatment of opportunistic infections difficult.
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PMID:Clinical aspects of HIV infection in developing countries. 305 40

A retrospective clinical and pathological analysis has been performed of 24 cases of herpes simplex virus encephalitis (HSE) seen at the Institute of Neurological Sciences, Glasgow, between 1972 and 1985. All patients had been diagnosed on the basis of isolation of herpes simplex virus (HSV) from, and/or the demonstration of characteristic histological changes of acute necrotizing encephalitis (ANE) in brain biopsy and/or autopsy tissue. Clinical presentation on admission included a prodromal influenza-like illness (46%), sudden onset of headache and confusion (54%), meningism (38%), deep coma (42%), aphasia (54%) and focal neurological signs (79%). Seizures occurred in 46% of cases during the course of the illness. Of the 24 cases, 14 (58%) died and 10 (42%) survived. Intravenous acyclovir treatment was associated with the best prognosis. Cerebral biopsy of one temporal lobe was performed in 22 cases and in 19 of these a positive histological diagnosis of HSE could be made. HSV was isolated from 15 of the 19 (79%) biopsied cases in whom virus isolation was attempted. Only seven out of the 15 cases (47%) in which immunofluorescence assays for HSV antigens were performed were unequivocally positive. Herpes simplex virus was isolated in culture from all cases which were negative by immunofluorescence. Immunocytochemical analysis on tissue sections of five representative brain biopsies demonstrated the presence of HSV antigens in some astrocytes, neurons and macrophages especially within areas of inflammatory infiltration. In situ hybridization experiments with a cloned HSV DNA probe demonstrated viral RNA in astrocytes, neurons and macrophages in two human biopsies and mouse brains in areas broadly corresponding to the distribution of viral antigen labelling. The combined immunocytochemical and in situ hybridization procedure showed that many but not all of the cells containing viral RNA also contained HSV antigens, indicating a productive infection in these double-labelled cells.
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PMID:A clinico-pathological study of herpes simplex encephalitis. 320 Mar 68

The clinical features, investigative profiles and outcome of 46 patients with biopsy or autopsy-proven herpes simplex encephalitis admitted to the Institute of Neurological Sciences, Glasgow between 1962 and 1985 were analysed retrospectively. The protean presenting symptoms and signs included a history of a prodromal influenza-like illness (48 per cent), rapid onset of headache, clouding of consciousness and confusion (52 per cent), meningism (65 per cent), raised intracranial pressure (33 per cent), deep coma (35 per cent), mutism or aphasia (46 per cent), focal neurological signs (89 per cent), and seizures (61 per cent). When seizures occurred they were almost always focal. The electroencephalogram was the most useful diagnostic test being abnormal in all cases, the majority showing focal changes in one or other hemisphere. Of the neuroradiological procedures employed, computerized tomographic and isotope brain scanning most frequently demonstrated localizing abnormalities in one or both temporal and/or frontal lobes. Midline shift was seen in half the cases. The cerebrospinal fluid was abnormal in every case but was not diagnostic. Cerebral biopsy of one temporal lobe was performed in 40 cases and a positive diagnosis of acute necrotizing encephalitis was made in 37 of these. Herpes simplex virus was isolated from the brains of 29 of the 40 cases in which the procedure was attempted, but immunofluorescence assays for antigens to herpes simplex virus were only positive in 11 out of 25 cases. Serological assays showed a greater than four-fold rise in the anti-herpes simplex virus antibody titre in 13 out of 22 patients tested.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A retrospective analysis of forty-six cases of herpes simplex encephalitis seen in Glasgow between 1962 and 1985. 325 5

Two patients had clinical findings of encephalopathy that progressed in 4 to 5 months. One patient had headache, fatigue, lethargy, hemiparesis, and a seizure. The second patient had only forgetfulness, confusion, and lethargy without focal signs. Herpes simplex virus was grown from brain biopsy in the first patient and from CSF in the second patient. These cases suggest that herpes simplex virus caused the encephalitis and that it should be considered in the differential diagnosis of chronic encephalopathy.
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PMID:Chronic encephalitis possibly due to herpes simplex virus: two cases. 403 28

Sixty patients with acute viral encephalitis admitted to The London Hospital in the last fifteen years have been reviewed. These consisted of 12 patients with known viral infection, 29 patients with acute viral infection of undetermined type, and 19 patients in whom an encephalitic illness followed a viral infection (post-infection encephalitis). The patients with primary viral encephalitis presented with an inflammatory brain disorder, including headaches and fever, and developed focal or diffuse neurological signs. Patients with post-infection encephalitis, usually following a 'flu'-like illness, presented with an acute neurological disturbance. The results of investigations, including virological studies, CSF examination, electroencephalography and neuroradiology, are described. Biopsy or autopsy material was available in 11 patients and these pathological findings supported the clinical classification of these patients. The mortality was highest in patients with herpes simplex virus encephalitis and lowest in patients with post-infection encephalitis. A considerable morbidity was found, not only in patients with primary viral encephalitis, but also in patients with encephalitis of unknown aetiology and post-infection encephalitis.
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PMID:Acute viral encephalitis: its diagnosis and outcome. 625 3

A 39-year-old man had acoustic hallucinations for about one year due to chronic alcoholism. He suddenly lost consciousness after suffering from headaches for about four weeks. EEG and CT scan were indicative of a brain tumour but lumbar puncture revealed slight pleocytosis and an immunoglobulin G fraction synthesized within the central nervous system. This secretory fraction contained major portions of locally produced herpes simplex antibodies detectable with a complement fixation test and a recently developed enzyme immunoassay. The patient remained in hospital for only a few days and went back to work after six weeks. To our knowledge this is the first case reported surviving herpes simplex encephalitis outside hospital without impairment of consciousness, confusion or substantial neurologic symptoms. The question remains open, whether the generally severe course of this disease had been modified by the chronic alcoholism. It is obvious that the correct diagnosis would have been missed without lumbar puncture.
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PMID:[Low-symptom herpes simplex encephalitis (author's transl)]. 628 60

We report a case of a 5-year-old girl with herpes simplex encephalitis (HSE) who was treated with adenine arabinoside (ara-A). The characteristic symptoms consisted of headache and vomiting followed by progressive disturbance of consciousness. CT scan revealed a translucent area in the left temporal lobe. Seven days after the onset vigorous treatment including ara-A was initiated. She recovered without apparent toxicity or sequelae except for mild motor aphasia. Our experience suggests that ara-A is effective in the treatment of HSE if given early enough.
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PMID:Herpes simplex encephalitis treated with adenine arabinoside. 630 4

A case of severe generalised herpes simplex type 2 infection is described in an adult male who had known exposure to herpes. The patient first complained of headache, fever and neurological symptoms, and three to six days later of conjunctivitis, severe pharyngitis, arthralgia and vesicular lesions about the body. During the first 14 days of illness, including three in hospital, the patient was diagnosed as having infection with varicella virus, vesicular stomatitis virus, or hand-foot-and-mouth disease virus. The diagnosis of infection with herpesvirus was not considered until herpesvirus was visualised in vesicular fluid by electron microscopy six weeks after onset. HSV-2 was then repeatedly isolated from vesicular fluids over the next four years. Detailed serological tests on the patient's sequential serum samples demonstrated a specific and continued response to HSV-2. He possibly acquired the virus iatrogenically, either by oral droplet transmission into or finger contamination of a PPD injection site, from the nurse who administered the injection and then palpated the site.
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PMID:Herpes type 2 infection with unusual generalised manifestations and delayed diagnosis in an adult male. 687 92

A 48-year-old male was admitted to our hospital because of fever, headache and vomiting. At admission, the level of consciousness was depressed (drowsy) with slight confusion. Extremely miotic pupils, nuchal stiffness, ataxia and myoclonic movements of both upper limbs were observed. The eye movements were almost normal and there was no definite limb weakness or sensory impairment. A few days after admission, his level of consciousness further decreased, and opsoclonus, ataxic breathing and intestinal paralysis appeared. The body temperature fluctuated remarkably ranging from 33.0 degrees C to 39.0 degrees C. The cerebrospinal fluid (CSF) examination revealed lymphocytic dominant pleocytosis, increase of protein and decrease of glucose. Enzyme-linked immunosorbent assay (ELISA) showed increased antibody (IgG) to herpes simplex virus (HSV) in both serum and CSF. The antibody in CSF further elevated at the later examination. Magnetic resonance imaging (MRI) demonstrated high signal intensity areas mainly in the cerebellum and sporadically in the supratentorial subcortical white matter on T2-weighted images. Administration of Gadolinium-DTPA also revealed an additional lesion in the pons. From these findings, he was diagnosed as herpetic encephalitis involving the brainstem and the cerebellum, and acyclovir was administered. Although his initial symptoms and signs started to recover three weeks after admission, he newly developed complete flaccid paraplegia, dysuria and sensory disturbance with the spinal cord level of the 4th thoracic segment. The oligoclonal IgG bands were detected in the cerebrospinal fluid of the convalescent stage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Herpetic simplex encephalitis followed by myelopathy]. 836 51

We studied the painful symptoms associated with human immunodeficiency virus (HIV) infection and its treatment in a group of men enrolled in a prospective longitudinal study of HIV effects on the nervous system. The most common painful illnesses reported were HIV-related headaches, herpes simplex, painful peripheral neuropathy, back pain, herpes zoster, 3'-azido-3'-deoxythymidine (AZT)-induced headaches, throat pain, and arthralgia. Painful illnesses were reported at all stages of systemic disease but were more common in the later stages of disease and in subjects who progressed to a more advanced stage during the study period. There was an association between the frequency of multiple pains, increased disability on the Karnofsky scale, and higher depression scores, as measured by the Brief Symptom Inventory (BSI). We conclude that painful symptoms are important even in relatively healthy and independent HIV-infected men.
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PMID:Painful symptoms reported by ambulatory HIV-infected men in a longitudinal study. 837 98


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