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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Traditional treatment of otosyphilis with penicillin and corticosteroids has achieved hearing improvement; however, selecting which patients with a positive fluorescent treponemal antibody absorption (FTA-ABS) test will benefit from treatment remains a problem. In order to study this problem, 18 patients with cochleovestibular dysfunction of unknown etiology and positive syphilis serology were treated with intravenous penicillin and corticosteroids. In addition, lumbar puncture and human immunodeficiency virus (HIV) testing were performed on all patients. Hearing improved in 5 (31%) of 16 patients, tinnitus decreased in 11 (85%) of 13, and vertigo improved in 6 (86%) of 7. Factors associated with hearing improvement were hearing loss present less than 5 years, fluctuating hearing, and age less than 60. Improvement was unrelated to the severity of the loss or previous therapy. All patients with cerebrospinal fluid abnormalities, including two patients with HIV disease, had subjective improvements. A diagnostic and treatment protocol is presented.
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PMID:Otosyphilis: a diagnostic and therapeutic dilemma. 850 9

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.
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PMID:[Cryptococcosis caused by Cryptococcus neoformans var. Gattii. A case associated with acquired immunodeficiency syndrome (AIDS) in Kinshasa, Zaire]. 149 13

During the initial phase of clinical diagnosis and treatment of the manifestations of acquired immunodeficiency syndrome, involvement of the ear appeared minor. In the past several years, however, otologic disorders increasingly have been reported in individuals with human immunodeficiency virus (HIV), as well as in retrospective studies of such patients. The otologic data appear quite variable. Functionally, conductive hearing loss, unilateral and bilateral sudden or progressive sensorineural hearing losses, vertigo, and tinnitus have been reported. In addition, tissue responses in each division of the ear have been observed. Based on collective serologic and immunologic diagnostic assays, clinical histories, and temporal bone histopathology, otologic symptoms may not be the direct effect of HIV alone, but rather a combination of the effects of HIV infection coupled with that of opportunistic microorganisms and/or possible ototoxic effects of certain therapeutic agents. It is within this context that otologic findings in this population of subjects will be discussed.
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PMID:Otologic pathophysiology in patients with human immunodeficiency virus. 228 39

The thorough investigation of patients presenting with sudden or fluctuating hearing loss, ringing or vertigo includes serology to exclude otosyphilis. Treatment of otosyphilis with penicillin and corticosteroids has achieved improvement in hearing, tinnitus and vertigo, but not in all patients. Selecting which patient with positive serology will benefit from treatment remains a difficult clinical problem. All patients presenting to The New York Eye and Ear Infirmary with cochleovestibular dysfunction of unknown aetiology and positive syphilis serology were assumed to have otosyphilis and were treated with intravenous penicillin, if non-allergic, and steroids. Lumbar puncture and HIV testing were performed. Eighteen patients were treated. Hearing (SRT and/or discrimination) improved in 4 of 16 patients with hearing loss (25%), tinnitus decreased in 10 of 14 (71%) and dysequilibrium improved in 6 of 9 (66%). Factors associated with a good response included fluctuating symptoms, especially hearing, hearing loss less than five years, and age less than 60. Improvement was unrelated to the severity of the loss or previous therapy. Patients with CSF abnormalities, including two patients with HIV disease, had subjective improvement. A summary of our results and a treatment protocol are presented.
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PMID:Otosyphilis: diagnostic and therapeutic update. 815 33

In patients with HIV infection, oral and pharyngeal pathology frequently occurs, but there have been no reports on cases of deafness in Japan. Herein, the authors report two cases of sensory neural hearing loss in hemophilia A patients infected with HIV through factor VIII concentrates. Case 1 was a 16-year-old male with hemophilia A. He had been administered factor VIII concentrates starting at 6 months after birth. At 8 years of age, HIV antibodies were positive. He was diagnosed as having AIDS after suffering from pneumocystis carinii. He complained of right otalgia and slight vertigo during treatment for a relapse of the pneumocystis carinii. He underwent otological examinations at our department. The right tympanic membrane showed opacification and serous otorrhea was noted. Acute otitis media was diagnosed and tympanotomy was conducted. Afterwards, the right tympanic membrane developed a large perforation and sensory neural hearing loss occurred. Case 2 was a 49-year-old male with hemophilia A. He had been administered factor VIII concentrates from the age of 23 years. At 48 years of age, HIV antibodies were positive. The patient complained of sudden deafness in the right ear and slight vertigo. He underwent otological examinations at our department. The tympanic membrane was normal bilaterally, but sensory neural hearing loss was found in the right ear. It was presumed that acute otitis media directly involving the inner ear had caused a perceptive disorder in case 1 while a pattern of sudden onset of deafness was apparent in case 2.
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PMID:[Two cases of sensory neural hearing loss as a manifestation of HIV infection]. 852 68

The 33-year-old woman was violently beaten and suffered from concussion of the upper abdomen. Because of pain she took mefenamic acid for two days. Then she reported hematemesis, melena and vertigo. The value for hemoglobin was determined as 5.8 g/dl. Acute blood loss was suspected, but neither intraabdominal nor upper gastrointestinal hemorrhage could be detected. Further investigations revealed a Coombs-negative hemolytic anemia and thrombocytopenia, and microangiopathic hemolysis was suggested by the detection of fragmentocytes in a peripheral blood smear. The diagnosis of thrombotic thrombocytopenic purpura (TTP) was made, though the patient did not suffer from manifestations of impaired microcirculation like neurological symptoms or renal failure. The TTP was found to be associated with HIV infection. The hematological disease responded well to the treatment with fresh-frozen plasma.
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PMID:[Emergency admission with suspected anemia-causing bleeding in the upper gastrointestinal tract]. 896 48

We report a case of a 23 years old woman HIV positive for the past five years with a four year history of right perceptive hypoacusia evolution without tinitus, vertigo or any other otologic symptomatology. After reviewing her personal and family history and conducting imilar tonal audiometry, tympanometry bilateral, contralateral estapedial reflex, auditory evoked brain stem response and a bilateral nasal fiberendoscopy, we analyzed the evolution of her immunal deficiency and the treatments to which she has been submitted with the purpose of determining the risk factors that have coincided in this case to be able to establish some criteria to follow the auditive affect in HIV positive patients.
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PMID:[Perceptive deafness and AIDS]. 924 22

Ritonavir (RTV), a protease inhibitor, and carbamazepine (CBZ), an anticonvulsant, were administered concurrently to a patient who had human immunodeficiency virus infection and epilepsy. The combination resulted in elevated serum concentrations of CBZ, with accompanying vomiting, vertigo, and transient liver dysfunction. After discontinuing RTV and reducing the dosage of CBZ, the serum concentration of CBZ returned to the optimal range, symptoms subsided, and liver function returned to baseline. Carbamazepine is metabolized in the liver to a large extent by the cytochrome P450 (CYP) system, especially CYP3A4, 2C8, and 1A2, whereas RTV is metabolized primarily by CYP3A and is a potent inhibitor of this enzyme. Careful clinical monitoring may help prevent adverse drug interactions when these drugs are administered concurrently.
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PMID:Potential interaction between ritonavir and carbamazepine. 1090 77

A Nigerian man had acute onset of headache and vertigo due to a cerebellar mass. A brain biopsy of the mass revealed toxoplasmosis despite repeated negative HIV-1 serology. The presence of an opportunistic infection and his country of origin raised the suspicion for HIV-2; this was confirmed by positive HIV-2 serology. Despite his preliminary pathological diagnosis, results of physiological magnetic resonance imaging (MRI) (perfusion MRI and proton magnetic resonance spectroscopy) were not typical for toxoplasmosis. The lesion showed a biochemical and perfusion pattern that was intermediate for infectious and neoplastic processes. Further neuropathology confirmed a secondary diagnosis of lymphomatoid granulomatosis.
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PMID:HIV-2 infection with cerebral toxoplasmosis and lymphomatoid granulomatosis. 1129 96

In acquired human immunodeficiency virus (HIV) infection, a long depolarization period at ECG may be the consequence of cardiac complications due to viral myocarditis or cardiomyopathy or indirectly due to autonomic neuropathy, or sometimes resulting from pharmacological treatments. Several drugs administered for direct treatment of HIV disease or its complications, such as antiretrovirus, fluconazole, and antibiotics, may induce ventricular arrhythmias due to long QT prolonged depolarization period. Also methadone, frequently associated with HIV therapy to treat patients with opiate addiction, is described in the literature to have cardiac inotropic effects. It has also the potential to increase the QT period and to develop ventricular torsade de pointes, primarily through interference with the rapid component of the delayed rectifier potassium ion current. Moreover, the use of methadone associated with other inhibitors of cytochrome P450 might increase plasma concentrations and contribute to methadone cardiac toxicity. We report the case of an HIV patient receiving antiretroviral treatment, fluconazole and high-dose methadone, who suddenly complained of vertigo, dizziness, pre-syncope and syncope due to severe ventricular arrhythmias that disappeared after discontinuation of all treatments.
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PMID:[Long QT and torsade de pointes in a patient with acquired human immunodeficiency virus infection in multitherapy with drugs affecting cytochrome P450]. 1556 12


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