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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Histoplasmosis of the choroid plexus has not previously been described. We report its occurrence, as well as its clinical, pathologic, and imaging characteristics in one case. Clinically, our patient's choroid plexus lesion produced encephalopathy and third nerve palsy. On imaging it appeared as a hemorrhage or calcification. Cerebrospinal fluid studies were consistent with a chronic meningeal process uncomplicated by hemorrhage. Stereotactic biopsy of the choroid plexus was required to establish the diagnosis of cerebral histoplasmosis. Pathologic examination also revealed prominent abnormal calcification, which permitted the lesion of masquerade as a hemorrhage on computed tomographic and magnetic resonance images.
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PMID:Choroid plexus histoplasmoma: clinical, pathologic, and imaging findings. 879 Mar 16

At the end of 1984, there were about 1.5 million children worldwide infected with HIV-1. 75% of these children lived in sub-Saharan Africa and Latin America. The rate of mother-to-child transmission of HIV-1 is estimated to range from 13% to 42%. It is twice as high in Africa as it is in Europe. By the year 2000, 6 million pregnant women and 5-10 million children will be infected with HIV-1. It appears that clearance of HIV-1 infection occurs in 2.7% to 6.4% of infected infants. Possible intervention strategies to reduce perinatal HIV-1 transmission include antiretroviral therapy with zidovudine, recommending breast feeding only in areas where it is clearly necessary, cesarean section, passive immunotherapy with anti-HIV immunoglobulins, and viral envelope subunit vaccines. An accurate diagnosis of HIV-1 infection can occur in non-breast fed infants born to seropositive mothers by the age of 3 months. Most children (80-90%) with HIV-1 infection develop features of HIV-1 infection within the first year of life. Common manifestations in the first year are lymphadenopathy, splenomegaly, and/or hepatomegaly. Young infants, especially those 3-6 months old, are more likely to be diagnosed with Pneumocystis carinii pneumonia (PCP) than older HIV-1 infected children. HIV-1 infected children are more likely to develop PCP, serious bacterial infections, cytomegalovirus infection, lymphoid interstitial pneumonitis, and encephalopathy than adults. They are, however, less likely to develop other opportunistic infections (e.g., toxoplasmosis, tuberculosis, cryptococcoses, and histoplasmosis). Possible underlying mechanisms of disease progression in HIV-1 infected children include presence of rapidly replicating syncytium-inducing HIV-1, high virus burden, persistent neutralizing antibody response, antibody-dependent cellular cytotoxicity against HIV-1, and transplacental passage of maternal neutralizing antibodies.
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PMID:Paediatric HIV infection. 894 23

We recently treated a patient with adult-onset Still's disease who developed macrophage activation syndrome (MAS) secondary to disseminated histoplasmosis while being treated with adalimumab. The gastroenterology service was consulted early, before diagnosis, as the patient presented with elevated liver enzymes and disseminated intravascular coagulation. MAS is an exaggerated immune response that can develop as a primary condition or secondary to infections, drugs and various diseases, resulting in liver dysfunction, encephalopathy, pancytopenia and disseminated intravascular coagulation. The development of MAS has also been reported in patients with inflammatory bowel disease and post-liver transplantation and has been triggered by medications used by gastroenterologists, particularly sulfasalazine and anti-tumor necrosis factor biologic modifiers. Therefore, we present a review on etiology, pathogenesis, clinical and laboratory features, and treatment of MAS with a focus on gastrointestinal aspects and presentations. MAS is a life threatening condition with a high mortality rate if untreated. Therefore it is important to recognize this condition early. As these patients may occasionally present to gastroenterologists we hope this review will increase awareness of this rare, but serious syndrome.
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PMID:Macrophage activation syndrome: why and what should a gastroenterologist know. 2092

The cause of posterior reversible encephalopathy syndrome (PRES) is often multifactorial. It is uncommon in patients with human immunodeficiency virus (HIV) infection. However, if the cause of PRES is left untreated it can cause significant morbidity and mortality. Thus, we believe it should be included as a differential in immunosuppressed patients presenting with neurological signs. This case report describes such a patient with acquired immunodeficiency syndrome (AIDS) who developed hypocalcaemia secondary to disseminated histoplasmosis.
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PMID:Posterior reversible encephalopathy syndrome in disseminated histoplasmosis and advanced HIV infection. 2442 96