1/1074. Supraventricular tachycardia in a human immunodeficiency virus-infected man.Although supraventricular tachycardias and human immunodeficiency virus infections are common diseases by themselves, a combination is not so common. Such a patient was encountered recently and described in this case report. Because misdiagnosis of tachyarrhythmias is not uncommon and may lead to inappropriate therapy-frequently resulting in acute clinical deterioration or even death, a discussion of management of supraventricular tachyarrhythmias in general was included. The recent introduction of adenosine into clinical use provides an effective agent in, and revolutionizes, the management of patients with supraventricular tachyarrhythmias. Its application, both for diagnostic and for therapeutic purposes, was discussed in some details in this report.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
2/1074. stroke and seizures as the presenting signs of pediatric HIV infection.The authors report two pediatric patients with definite human immunodeficiency virus infection whose initial presentation was stroke and seizure. The first patient was a 3-year-old female who developed acute hemiparesis as the first manifestation. The other, a 2-month-old infant, had focal seizures secondary to cerebral infarction. Investigations revealed ischemic infarction of the thalamus, hypothalamus, and internal capsule in the first patient and cerebral cortex in the second. Further investigations failed to demonstrate any other causes of these cerebral infarctions. Opportunistic infection of the central nervous system was not documented. The authors emphasize that cerebrovascular accident may be the initial presentation in human immunodeficiency virus infection in children. Human immunodeficiency virus infection must be included in the differential diagnosis, and testing for the disease is mandatory in the investigation of stroke in any child who is at risk of having this infection.- - - - - - - - - - ranking = 0.6keywords = immunodeficiency (Clic here for more details about this article) |
3/1074. Primary pulmonary hypertension in a patient with HIV infection.Several case-reports and small series suggest a causal relationship between human immunodeficiency virus (HIV) infection and pulmonary hypertension. We report on a HIV seropositive man with a high and stable cd4 lymphocyte count ( /- 600/mm3) who developed severe pulmonary hypertension, not attributable to other known causes. This case report underscores the fact that the degree of immunosuppression secondary to the HIV-infection seems to be of little relevance in the pathophysiology of the syndrome. HIV-infected patients with dyspnoea, not related to pulmonary infection, with exercise intolerance, syncope or precordial pain should receive an electrocardiogram and echocardiographic assessment. The exact pathogenetic mechanism of this rapidly progressive disease and whether anti-viral therapy should be promoted is still under investigation.- - - - - - - - - - ranking = 0.2keywords = immunodeficiency (Clic here for more details about this article) |
4/1074. Adrenal suppression in children with the human immunodeficiency virus treated with megestrol acetate.Symptoms and laboratory evidence of adrenal suppression developed in 2 children with the human immunodeficiency virus after megestrol acetate (MA) therapy was discontinued; both required transient glucocorticoid replacement therapy. High-dose corticotropin stimulation testing performed on children with the human immunodeficiency virus treated or not treated with MA showed that baseline and post-corticotropin cortisol levels were extremely low in 7 of 10 treated patients and normal in 10 of 10 members of a control group (P <.01). MA may suppress adrenal function, and replacement glucocorticoids may prevent or relieve associated symptoms at times of severe stress or on discontinuation of MA therapy.- - - - - - - - - - ranking = 1.2keywords = immunodeficiency (Clic here for more details about this article) |
5/1074. meningioma in four patients with human immunodeficiency virus infection.We describe four patients infected with the human immunodeficiency virus (HIV) who had development of meningiomas. In contrast to those in the general population who have meningiomas, all our patients were young men; the mean age was 40 years (range, 32 to 50). Their risk behavior for HIV was homosexuality (three patients) and intravenous drug use (one patient). The CD4 cell count in each of the three homosexual men was less than 50/microL and was 280/microL in the drug user. Imaging studies showed enhancing lesions in three of the patients. Although each of these meningiomas could have occurred in otherwise normal young to middle-aged men, we speculate that the meningiomas may have grown in these HIV-infected hosts because of either loss of immune function or dysregulation of cytokines.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
6/1074. Synovial non-Hodgkin's lymphoma in a human immunodeficiency virus infected patient.We describe a case of articular non-Hodgkin's lymphoma (NHL) with malignant lymphoma cells observed in synovial fluid. Bone involvement in NHL is common, but an English language medline search revealed only 14 reported cases of synovial NHL. Although NHL is a well recognized complication of human immunodeficiency virus (HIV) infection, this is the first report of synovial NHL in an HIV infected patient.- - - - - - - - - - ranking = 1keywords = immunodeficiency (Clic here for more details about this article) |
7/1074. hiv-1 (p24)-positive multinucleated giant cells in HIV-associated lymphoepithelial lesion of the parotid gland. A report of two cases.BACKGROUND: Cystic benign lymphoepithelial lesion (CBLL) is a well-recognized parotid disorder the diagnosis of which can be made on the basis of clinical findings, human immunodeficiency virus (HIV) testing, image studies and fine needle aspiration (FNA). Most aspirations are cystic, and the lesion can be recognized if the triad of foamy macrophages, lymphoid and epithelial (squamous) cells is observed. CASES: The authors recently observed FNA cytologic features of two HIV-associated cases that exhibited numerous multinucleated giant cells (MGCs) but failed to show the epithelial component. A subsequent surgical resection was performed in one patient. Similarly to what has been described for nasopharyngeal (adenoid and tonsil) lymphoid tissue of HIV-positive patients, intense immunoexpression of S-100 and p24 (hiv-1) protein was present in MGC. CONCLUSION: The diagnosis of HIV-associated CBLL should always be considered if a parotid cystic lesion presents with numerous MGCs. Immunocytochemical detection of p24 (hiv-1) protein in MGC becomes a very useful diagnostic aid and extends to parotid CBLL many of those pathogenic features of hiv-1 infection already noted in other hiv-1-infected, lymphoid oropharyngeal lesions.- - - - - - - - - - ranking = 0.2keywords = immunodeficiency (Clic here for more details about this article) |
8/1074. syphilis in an HIV infected patient misdiagnosed as leprosy.A 42-year-old man with uveitis and a widespread cutaneous eruption, histopathologically characterized by dermal granulomatous infiltrates with perineurial invasion, was incorrectly diagnosed and treated as having borderline leprosy. Further studies demonstrated secondary syphilis and human immunodeficiency virus (HIV) infection. Standard penicillin therapy resolved his cutaneous and ocular lesions. Reports on clinical and pathological findings of active syphilis in HIV infected patients are scarce but this case and isolated previous case reports suggest that granulomatous infiltrates might be a common feature in secondary syphilis with short evolution in HIV infected patients.- - - - - - - - - - ranking = 0.2keywords = immunodeficiency (Clic here for more details about this article) |
9/1074. Sonographic and MR findings of an extensive, HIV-related prostatic abscess.We present findings in a patient positive for the human immunodeficiency virus in whom a prostatic abscess involving the entire gland was diagnosed by transrectal ultrasonography and magnetic resonance imaging (MRI); he was subsequently treated by transurethral resection, drainage, and antibiotics. To our knowledge, this is the first report of a pelvic phased-array coil MRI performed in a patient with prostatic abscess.- - - - - - - - - - ranking = 0.2keywords = immunodeficiency (Clic here for more details about this article) |
10/1074. methadone withdrawal when starting an antiretroviral regimen including nevirapine.Antiretrovirals from three drug classes, nucleoside analogs, nonnucleoside analogs, and protease inhibitors, can be combined to achieve viral suppression. The nonnucleoside analog nevirapine is an inducer of cytochrome P450 3A4 liver metabolism and has interactions with protease inhibitors and oral contraceptives. methadone has two roles in human immunodeficiency viral infection: pain management and treatment of opioid abuse. A drug-drug interaction may result in decreased methadone blood levels when administered with nevirapine. A patient experienced methadone withdrawal symptoms when combining these agents.- - - - - - - - - - ranking = 0.2keywords = immunodeficiency (Clic here for more details about this article) |
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