Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case of ischemic stroke related to Herpes zoster infection of the eye and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital Universitario de Santa Maria, Lisbon. She presented with a 5-month history of sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among extensive diagnosis tests, she was positive for HIV by ELISA and Western blot, hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the distribution of the 1st division of the left trigeminal nerve, and right spastic hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was 0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus, Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial infections, but her stool contained Trichuris trichiura eggs and giardia lamblia cysts. Her cardiovascular system and cerebrovascular fluid were negative. Computed tomography of the head showed an old left capsular infarct. Cerebral angiography showed arteritis of the left choroidal artery with occlusion. She was treated with metronidazole and mebendazole, and had surgery for removal of the left eye with a prosthetic replacement. Strokes are common in AIDS patients, resulting from fungal infections, endocarditis, infectious or non-infectious emboli, or arteritis from herpes zoster infections. This is the 1st published case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.
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PMID:Herpes zoster and controlateral hemiplegia in an African patient infected with HIV-1. 186 23

A male intravenous drug abuser who was infected with hepatitis B and C, presented with a slowly progressive hemiplegia. Contrast enhanced computerized tomography of the head showed a solitary ring-enhanced mass with surrounding edema. Clinically brain tumor was suspected but a brain biopsy confirmed cerebral toxoplasmosis. An HIV test was not considered until the result of brain biopsy. He also had lymphopenia and positive serum toxoplasma antibody. His subsequent HIV test was positive. He deteriorated after a brain biopsy. Empirical antitoxoplasma treatment is recommended in HIV-positive patients with ring-enhanced lesions with surrounding edema and with positive toxoplasma serology. Cerebral toxoplasmosis is still the commonest cerebral opportunistic infection in HIV-infected patients even though the incidence has declined with the use of antiretroviral therapy. It is often diagnosed in those patients as an initial presentation of HIV infection or in those who failed to attend for disease monitoring. Clinical features and differential diagnosis of cerebral toxoplasmosis in immunocompromised patients are discussed.
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PMID:A 'brain tumor' in an intravenous drug abuser. 2036 Aug 90

Purple urine bag syndrome (PUBS) is a rare syndrome characterized by production of indigo (blue) and indirubin (red) pigments due to bacterial colonization in urinary catheter. The pathogenesis of PUBS is related to the combination of these two pigments produced from the metabolism of tryptophan. Tryptophan turns into indole by deamination, indole turns into indoxyl sulphate by hepatic conjugation and indoxyl sulphate is secreted into urine. Sulphatases and phosphatases enzymes produced by bacteria like Providencia stuartii and Providencia rettgeri, Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli, Enterococcus spp., Morganella morganii, Pseudomonas aeruginosa, Citrobacter spp. and group B streptococci convert indoxyl sulphate to indoxyl. In the urinary tract, oxidation of indoxyl results in the production of indigo and indirubin pigments. These pigments react with polyvinyl chloride (PVC) lining of the urinary catheter bag and the reaction results purple discoloration of urine. Urine discoloration is very important clinical sign in the differential diagnosis of several pathological conditions such as hematuria, urinary system tumors and drug side effects and may be disquieting for patients, families and healthcare workers. Purple urine discoloration is rarely reported in the literature and it is generally associated with urinary tract infection. In this report, a 60 years old woman with a past medical history of significant chronic kidney disease undergoing regular hemodialysis, chronic constipation and hepatitis B was admitted to our neurology clinic because of acute intracerebral hemorrhage. She had confusion and right hemiplegia in her neurological examination and required urinary catheterization due to immobilization. Red coloration was observed in urine on the tenth hospital day. Although this coloration was thought to be hematuria, according to urine examination it was not hematuria. Then urine color turned into purple within two days. The next day, because of fever, full blood count and other blood investigations were performed and urine was sent to the laboratory for culture. Empirical piperacillin-tazobactam and teicoplanin antibiotic treatments were commenced. In the urine culture, 105 cfu/ml Enterococcus faecalis was isolated. According to the antibiotic susceptibility results the therapy was changed and meropenem was added to the treatment. For her constipation, supportive managements such as hydration, nutrition and laxative treatment were applied. After all the treatments, the patient's constipation regressed, the urine had become normal colored and the following urine cultures were not revealed any bacterial growth. As in this case, when the urine discoloration occurs, PUBS should be kept in mind which is especially seen in elderly female patients with chronic constipation, urinary catheterization, urinary tract infection and renal failure.
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PMID:[Purple Urine Bag Syndrome: A Rare Clinical Case]. 3170 43