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Query: UMLS:C0019693 (
HIV
)
170,526
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The case of a 10.5-year-old girl, who was diagnosed with a case of thalassemia major at the age of 8 months and had been on regular blood transfusions since then, is related. Donor screening for
HIV
was started in mid-1988, thus she had received unscreened blood for a number of years. In February 1991, she presented with a dry persistent cough, moderate grade continuous fever, and breathlessness on exertion for over 2 weeks. Chest X-ray showed bilateral infiltrations. She was put on penicillin and chloramphenicol with a provisional diagnosis of bronchopneumonia. In March 1991, she had to be hospitalized for impending respiratory failure. After treatment with intravenous fluids and parenteral antimicrobials, her condition stabilized and she was discharged. In April 1991, she was readmitted because of complaints of difficulty in swallowing and weight loss. Her chest signs had persisted and she had developed oropharyngeal candidiasis with ulcerations. She also had alopecia, a generalized lymphadenopathy, digital
clubbing
, and bilateral parotid enlargement. Candidiasis responded to vigorous therapy with clotrimazole. Fine needle aspiration of lymph node showed a reactive hyperplasia.
HIV
antibodies were detected in the serum with ELISA and confirmed by Western blot. Immunologic tests showed evidence of severe immunodeficiency. The Multitest CMI, which simultaneously tests delayed skin hypersensitivity to seven common recall antigens, was totally nonreactive. She was classified as having AIDS according to World Health Organization criteria for children under 13 years of age. The diagnosis of lymphocytic interstitial pneumonitis (LIP) was also made based on the symptoms. Oral prednisolone was given 2 mg/kg/day in 3 divided doses for a month. The cough and dyspnea showed great improvement and the parotid swellings disappeared; lymphadenopathy,
clubbing
, and alopecia, however, persisted. The child was kept on maintenance therapy of prednisolone and on alternate day co-trimoxazole for prophylaxis against Pneumocystis carinii infection.
...
PMID:Acquired immunodeficiency syndrome (AIDS) with lymphocytic interstitial pneumonitis (LIP) in a multi transfused child with thalassemia major. 129 97
A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger
clubbing
, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain.
HIV
-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.
...
PMID:Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report. 851 33
We describe two patients who developed
clubbing
shortly after
HIV
seroconversion. None of them had the full syndrome of hypertropic osteoarthropathy. Other causes of
clubbing
are unlikely. We suggest that
clubbing
may belong to the spectrum of arthropathies associated with
HIV infection
.
...
PMID:Clubbing in human immunodeficiency virus infection. 911 59
While it is unusual for children to present with finger
clubbing
, the authors began to frequently see such cases in the University of Malawi's Department of Pediatrics, College of Medicine.
Clubbing
was recognized in 52 children during February-May 1996. An 8-year-old boy died with a diagnosis of endomyocardial fibroelastosis. The remaining 51 children were aged 4 months to 12 years of mean age 37 months. 26 of the 31 children tested for infection with
HIV
were
HIV
-ELISA seropositive. A clinical diagnosis of pediatric AIDS according to the World Health Organization criteria was made in 35 cases. A provisional diagnosis of pulmonary tuberculosis was made in 29. Two of the older children had acid-fast bacilli in sputum; one was
HIV
-positive. Digital
clubbing
in Malawian children may be associated with chronic lung disease and
HIV infection
, presenting as early as infancy. In regions where childhood
HIV infection
is common and resources are scarce, clinical findings which improve diagnostic specificity could prove useful.
...
PMID:Finger clubbing and HIV infection in Malawian children. 904 18
We investigated the frequency of finger
clubbing
in 150
HIV
-infected children consecutively hospitalized for acute pneumonia in South Africa and described associated clinical, laboratory and radiological features.
Clubbing
occurred in 30 of 150 (20%)
HIV
-infected children compared with one of 99 (1%)
HIV
-negative control patients, p < 0.001.
Clubbing
was associated with lower presenting heart and respiratory rates and enlarged parotid glands. Total and CD4 + lymphocytes, CD4:CD8 ratio and LDH were lower in children with
clubbing
, but serum protein and gammaglobulin were higher. No differences in the prevalence or type of microbial pathogens were found between the two groups.
Clubbing
was associated with a radiological diagnosis of LIP. Children with
clubbing
had a lower in-hospital mortality rate than those without
clubbing
(6.7% vs 24.2%, p = 0.035). In geographical areas with high
HIV
seroprevalence rates, the presence of
clubbing
in a child hospitalized for respiratory disease should raise the suspicion of
HIV infection
.
...
PMID:Finger clubbing in children with human immunodeficiency virus infection. 1128 40
In order to determine the trend in childhood tuberculosis, case records of children diagnosed and treated for tuberculosis between January 1981 and December 1995 at the paediatric tuberculosis clinic of the University of Benin Teaching Hospital were reviewed. Of 8,829 paediatric medical cases, 1,026 (11.6%) were managed as tuberculosis. The proportion of tuberculosis cases increased steadily over the study period from 6.9% in 1981 to 22.1% in 1995. An apparent decrease in the number of cases in 1985 (6.6%) was attributable to a strike by medical personnel. The clinical pattern of tuberculosis during the study period shifted toward the adult type with disseminated and cavitating lesions predominating in later years. Additionally, the severity of the disease increased with the incidence of both haemoptysis and finger
clubbing
increasing from 1.6% in 1981 to 14.2% and 18.2%, respectively, in 1995. Possible reasons for these findings include increased prevalence of malnutrition in childhood, increasing tuberculosis in the adult population and the effects of
HIV
/AIDS.
...
PMID:Trend in childhood tuberculosis in Benin City, Nigeria. 1147 Dec 57
Lymphocytic interstitial pneumonitis (LIP) is a non-infective lung condition common in untreated older children with vertically acquired
HIV infection
. Little is known about the prognosis in children with LIP, and diagnosis remains a problem where lung biopsy is not feasible. Our aim was to determine which clinical features aid the diagnosis of LIP in conjunction with the typical reticulonodular radiological picture, and whether the prognosis in children with LIP is different from that in
HIV
-infected children of the same age without LIP. We retrospectively compared the clinical features and T-cell subsets of 49 children with LIP with those of 56 children of similar age without LIP. Diagnosis of LIP was made radiologically. All children were apyrexial at the time of X-ray and acute intercurrent infections and tuberculosis had been excluded as far as possible. Ages ranged from 24 to 112 months in the non-LIP group and from 24 to 120 months in the LIP group. Digital
clubbing
and reticulo-endothelial hyperplasia were significantly more common in children with LIP than in those without. Children with LIP tended to have lower CD4+ counts and CD4% and higher CD8+ counts and CD8%, which resulted in significantly lower CD4/CD8 ratios in children under 5 years with LIP. It is possible in most cases to diagnose LIP using a combination of clinical and X-ray findings, as long as every effort is made to exclude tuberculosis. Lower CD4+ counts and CD4% as well as more frequent hospital admissions suggest that LIP adversely affects prognosis in children with
HIV
.
...
PMID:Clinical features and T-cell subsets in HIV-infected children with and without lymphocytic interstitial pneumonitis. 1157 57
The case is reported of a 53 year old long distance bus driver who had complained of fever, weight loss, abdominal and leg swelling and had a past history of inadequately treated pulmonary tuberculosis. Physical findings included generalised lymphadenopathy, finger
clubbing
, pedal oedem and chylous ascites. He tested positive for
HIV
type 1 and the histology of a lymph node biopsy was compatible with tuberculosis which responded favourably to antituberculous chemotherapy.
...
PMID:Chylous ascites, tuberculosis and HIV/AIDS: a case report. 1240 48
Cardiac complications contribute significantly to morbidity and mortality in
HIV
-infected children. There have been few reports of cardiac manifestations in
HIV
-infected children in developing countries. The aims of this study were to evaluate the clinical manifestations and echocardiographic findings in Thai children with
HIV infection
and determine the clinical predictors of left ventricular dysfunction and pulmonary hypertension. We retrospectively reviewed the medical records of 27 infants infected with
HIV
perinatally who presented with cardiovascular problems at a tertiary care hospital between 1995 and 2000. The mean age at initial cardiac evaluation was 36 months (range 8-65). Signs and symptoms included dyspnoea in all cases, oedema in 12 (44%), finger
clubbing
in 11 (41%), cyanosis in 6 (22%) and S(3) gallop in 8 (30%). Echocardiographic abnormalities included pericardial effusion in 12 (44 %), right ventricular dilatation in 12 (44%), pulmonary hypertension in 11 (41%), diminished left ventricular fractional shortening in 10 (37%), left ventricular dilatation in 9 (33%) and combined ventricular dilatation in 2 (7%). Left ventricular dysfunction did not correlate with
HIV
CDC classification, age, nutritional status or clinical signs and symptoms.
...
PMID:Cardiac manifestations in HIV-infected Thai children. 1518 44
A 13-yr-old girl born to healthy parents presented with cough, fever, easy fatiguability, photosensitivity and alopecia. She had
clubbing
and diffuse crackles in the chest on examination. Her CT scan of the chest showed evidence of bronchiectasis with consolidation. Investigations for tuberculosis and collagen vascular disease were negative. In due course she developed features of raised intracranial tension. Her blood for
HIV
ELISA was positive with CD4 counts of 17/ microL. Her CSF, sputum, blood and urine specimen were all positive for Cryptococcus neoformans on culture.
HIV
was not considered initially because of her atypical presentation. There was no history of sexual abuse, her parents were healthy and she did not receive any blood transfusion in the past.
...
PMID:HIV infection mimicking autoimmune disorder. 1778 5
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