Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019214 (hepatosplenomegaly)
4,408 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Physicians examined the records of 47 adults with visceral leishmaniasis (VL) and HIV-1 infection who were patients at 3 urban teaching hospitals in the Andalucia region in southern Spain between January 1986 and November 1991. They wanted to identify the clinical, biological, and epidemiological features of VL in HIV-1 positive patients. 96% of the cases were diagnosed with both infections during the last 2 years of the study period and 79% between January and November 1991. All the patients had risk factors for HIV infection (65.9% IV drug use, 21.3% sexual contact, and 12.8% blood transfusion). 70% exhibited the classic symptoms of VL (fever, enlarged liver and spleen, and depressed counts of blood cells). Most patients were already very immunocompromised when VL was diagnosed. 87% had a total lymphocyte count of less than 1000 x 1 million/1 and a CD4 lymphocyte count of less than 200 x 1 million/1. In fact, 66% had full blown AIDS prior to diagnosis of VL. VL was the first severe infection in 10 cases. 68% also suffered from opportunistic infections, especially candidiasis, extrapulmonary tuberculosis, and Pneumocystis carinii pneumonia. Microscopic examination of Leishmania amastiogotes in tissue samples led to a diagnosis in 94% of cases, isolation of motile amastigotes in culture of bone marrow aspirate in 2%, and microscopic and culture in 4%. Just 46% completed a full course of treatment (pentavalent antimony, allopurinol, and/or pentamidine). Only 38% had a microbiological response. Immunofluorescence detected sizeable titers (1:40) of antileishmanial antibodies in just 31% of cases. 17% experienced clear clinical improvement. Physicians in endemic areas should consider VL in every HIV-1 infected patient with fever, hepatosplenomegaly, or hematological abnormalities to avoid underdiagnosis of leishmaniasis.
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PMID:Visceral leishmaniasis in HIV-1-infected individuals: a common opportunistic infection in Spain? 136 80

Congenital cutaneous candidiasis (CCC) is a rare disease acquired by an ascending route, liable to affect the offspring of pregnant women suffering from vulvovaginitis. The cutaneous lesions are present at birth or within the first hours of life. Some infants may present with respiratory distress or clinical signs of sepsis during the first 2 days of life. We report four new cases of CCC, three of which presented transient respiratory distress and clinical signs of sepsis with hepatosplenomegaly. The evolution was favourable in all three cases with topical and oral therapy. We emphasize the self-limited character of this disease, although preterm infants may be at risk of systemic spread. Only one infant presented paronychia as a late complication.
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PMID:Congenital cutaneous candidiasis: report of four cases and review of the literature. 204 6

Nine black children aged between 3 months and 30 months of age, with human immunodeficiency virus type I (HIV-I) infection are described to draw the attention of health professionals in southern Africa to special clinical characteristics useful for recognising this problem, which has many shared features with common diseases of infancy and childhood in the Third World. The main presenting complaints were chronic cough and persistent diarrhoea and vomiting. These children frequently had diarrhoea (8 of 9 patients), mucocutaneous candidiasis (8), pneumonia (7), hepatosplenomegaly (9), significant lymphadenopathy (5) and wasting (5). All were infected by common bacteria, such as Gram-negative organisms, Mycobacterium tuberculosis and Campylobacter jejuni, or by opportunistic infections such as Candida or cytomegalovirus (CMV), or by both bacterial and opportunistic organisms. A raised total serum globulin level, anaemia, lymphopenia and a cerebrospinal fluid (CSF) pleocytosis were frequent findings. Incomplete data on parental HIV status suggest perinatal transmission. Three of the children were HIV-antigen positive. The diagnosis of full-blown acquired immunodeficiency syndrome (AIDS), using the stringent Centers for Disease Control criteria, is difficult in our situation because of limited diagnostic resources; however, using these criteria, and the clinical case definition for AIDS recommended by World Health Organisation, it is thought that probably 4 of these children could be considered as having AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some early observations on HIV infection in children at King Edward VIII Hospital, Durban. 223 85

Three children with acute lymphoblastic leukemia developed disseminated fungal disease predominantly involving the liver and spleen. The three patients were undergoing induction chemotherapy and had neutropenia when they presented prolonged fever not responsive to antibiotics. Once neutropenia was recovered, hepatosplenomegaly leukocytosis, elevated serum alkaline phosphatase, and hypoechoic areas in the spleen and liver ultrasound were observed. All fungal blood cultures were negative, with the diagnosis being confirmed by histologic study. One of the patients died without achieving control of the candidiasis. The other two patients received prolonged antifungal treatment concurrently with chemotherapy and both are alive, one of them cured and in complete remission. The increasing frequency of this infection in recent years and the importance of a prompt and prolonged administration of antifungal therapy to obtain the cure are discussed.
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PMID:Hepatosplenic candidiasis in children with acute leukemia. 229 57

A 60-year-old man with a one-year history of agnogenic myeloid metaplasia was admitted to the hospital because of fever and a skin eruption. He had fever, anemia, hepatosplenomegaly, and a raised painful erythematous plaque in the face. The same kind of skin lesion developed thereafter at a venipuncture site in the left forearm. Bacterial cultures were negative. There was no response to antibiotic treatment. A biopsy specimen of the skin lesion revealed a dense dermal infiltration with mature neutrophils. A diagnosis of Sweet's syndrome was made. Fever and skin eruptions responded rapidly to prednisolone (PSL). Although the disease frequently recurred on rapid tapering of PSL, skin lesions cleared without scarring on a prolonged course of PSL. Four months after withdrawal of PSL, Sweet's syndrome recurred. A high dose PSL was given without benefit. He died of disseminated candidiasis.
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PMID:[Acute febrile neutrophilic dermatosis (Sweet's syndrome) in a patient with agnogenic myeloid metaplasia]. 274 75

An eight-year-old child from Zaire died in Sweden in 1982 after a clinical course compatible with the acquired immunodeficiency syndrome (AIDS). In 1975, at the age of 5 months, the infant had an acute viral infection with a rash; this illness was followed by a chronic cough. During the course of the disease he had recurrent septicemia, fever (frequently with miliary lung infiltrates), disseminated lymphadenopathy, hepatosplenomegaly, candidiasis, and diarrhea. Late in the illness the child developed lethal disseminated disturbances of the central nervous system. Immunologic investigations revealed a pronounced hypergammaglobulinemia, normal C3 but low C4 values, decreased number of T-lymphocytes, and decreased lymphocyte stimulation with T-cell and B-cell mitogens. Samples of serum taken in 1981 and 1982 were analyzed and found to be positive for antibodies to HTLV-III virus. The course of the disease in this child was more prolonged than most of the pediatric cases described earlier. It is likely that this child developed AIDS early in 1975, long before the AIDS epidemic was apparent in the United States.
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PMID:Early case of acquired immunodeficiency syndrome in a child from Zaire. 301 6

Fourteen patients with the diagnosis of leukemia and one with lymphoma developed systemic candidiasis. Involvement of the liver (15 patients), spleen (nine patients), and kidney (five patients) was diagnosed by clinical, CT, and pathologic findings. The CT findings ranged from low-density lesions (11 livers, nine spleens, and five kidneys) to hepatomegaly or hepatosplenomegaly. All livers and three kidneys had positive biopsy findings for Candida. Two patients with diffuse splenic lesions underwent splenectomy and were proven to have candidiasis. During a 1 year follow-up, two patients developed hepatic calcifications and one developed renal calcifications. In proper clinical setting, CT should be done for simultaneous evaluation of the liver, spleen, and kidneys. These studies, when positive, are useful to guide percutaneous or open biopsy and to follow the results of therapy. However, regardless of the hepatic CT finding, biopsy should be obtained to establish the diagnosis and begin proper treatment.
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PMID:CT findings in hepatosplenic and renal candidiasis. 330 88

The acquired immunodeficiency syndrome has now been reported among more diverse groups of patients, and as each new category of patients is described, additional epidemiological and pathological insights are gained. Adult non-Haitian women with AIDS have so far generally been reported to have had male partners who have AIDS, are intravenous drug users or both. The present case is being reported because she was a non-Haitian, who did not use drugs and denied sexual contact with men. Pathologic and clinical findings in this case are consistent with AIDS and include: early generalized lymphadenopathy, pronounced lymphocytopenia, fever, hepatosplenomegaly, Kaposi's disease present, in lymph nodes, disseminated candidiasis, anergy to skin testing for delayed hypersensitivity reactions.
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PMID:Kaposi's sarcoma and T-cell lymphoma in an immunodeficient woman: a case report. 633 63

A 44-year-old woman with a history of intermittent fever for several years was admitted because of burn on her leg. On admission, she had hepatosplenomegaly and fever. Antibiotic therapy was started for bacterial infection of the burn. She lost her appetite and IVH was started. During the treatment, high fever appeared and chest X-ray films showed multiple nodular infiltrates throughout both lung fields. Candida albicans was isolated from IVH catheter culture and pulmonary candidiasis was suspected. Her fever and lung involvements were successfully treated with fluconazole. During the course, serum anti-EB-VCA-IgG antibody persisted at a high titer and anti-EBNA antibody remained negative. EB virus DNA was detected in the peripheral blood and bone marrow. Thus, she was diagnosed as chronic active EB virus infection.
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PMID:[A case with chronic active EB virus infection accompanied with pulmonary candidiasis]. 991 18

The WHO clinical case definition for pediatric HIV infection has been designed to be used in countries where diagnostic laboratory resources are limited. We evaluated the WHO case definition to determine whether it is a useful instrument to discriminate between HIV-positive and HIV-negative children. In addition, clinical features not included in this case definition were recorded. We recorded clinical data from 300 consecutively admitted children in a state hospital in Bloemfontein, South Africa, and tested these children for HIV infection. A total of 222 children were included in the study; 69 children (31.1 per cent) were HIV positive. The sensitivity of the WHO case definition in this study was 14.5 per cent, the specificity was 98.6 per cent. Apart from weight loss and generalized dermatitis, the signs of the WHO case definition were significantly more often seen in HIV-positive than in HIV-negative children. Of the clinical signs not included in the WHO case definition, marasmus and hepatosplenomegaly especially occurred more frequently in HIV-positive children. Based on these findings we composed a new case definition consisting of four signs: marasmus, hepatosplenomegaly, oropharyngeal candidiasis, and generalized lymphadenopathy. HIV infection is suspected in a child presenting with at least two of these four signs. The sensitivity of this case definition was 63.2 per cent, the specificity was 96.0 per cent. We conclude that in this study the WHO case definition was not a useful instrument to discriminate between HIV-positive and HIV-negative children, mainly because its sensitivity was strikingly low. The simplified case definition we propose, proved to be more sensitive than the WHO case definition (63.2 vs. 14.5 per cent), whilst its specificity remained high.
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PMID:Evaluation of the WHO clinical case definition for pediatric HIV infection in Bloemfontein, South Africa. 1284 2


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