scholarly journals Stroke in a patient with tuberculous meningitis and HIV infection

2013 ◽  
Vol 5 (1) ◽  
pp. e2013017 ◽  
Author(s):  
Maria Bruna Pasticci ◽  
Maurizio Paciaroni ◽  
Piero Floridi ◽  
Enisia Cecchini ◽  
Franco Baldelli
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Mycobacterium Tuberculosis ◽  
Side Effects ◽  
Hiv Infection ◽  
Tuberculous Meningitis ◽  
Clinical Manifestations ◽  
Treatment Needs ◽  
Caucasian Female ◽  
Meningeal Tuberculosis

Abstract. Tuberculous meningitis (TBM) is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

TRANSIENT ISCHEMIC ATTACKS: ETIOPATHOGENESIS, CLINIC. (Literature review)

Vestnik ◽  
2021 ◽  
pp. 91-96
Author(s):  
Г.Ж. Жакенова ◽  
Р.Б. Нуржанова ◽  
К.Б. Сраилова ◽  
Ж.С. Шерияздан ◽  
А.Б. Ташманова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Literature Review ◽  
Clinical Manifestations ◽  
Transient Ischemic Attacks ◽  
Review Of The Literature ◽  
Imaging Signs

В данной статье представлен обзор литературы по транзиторным ишемическим атакам: эпидемиология, этиология, патогенез, классификация, основные характеристики с учетом факторов риска, визуализационных признаков МРТ и КТ, клинических проявлений и дифференциальной диагностики данного заболевания на основе современных исследований. This article presents a review of the literature on transient ischemic attacks: epidemiology, etiology, pathogenesis, classification, main characteristics taking into account risk factors, imaging signs of MRI and CT, clinical manifestations and differential diagnosis of this disease based on modern research.

scholarly journals Problems of differential diagnosis of focal brain lesions in patients with HIV infection

2020 ◽  
Vol 12 (1) ◽  
pp. 35-39
Author(s):  
M. Yu. Fomina ◽  
M. A. Titova
Keyword(s):  
Differential Diagnosis ◽  
Hiv Infection ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
B Cell Lymphoma ◽  
Adverse Outcomes ◽  
Cns Lymphoma ◽  
Cerebral Toxoplasmosis ◽  
Therapy Regimen ◽  
Perinatal Hiv

Currently, the leading cause of social disadaptations and disability of patients at advanced stages of HIV infection, as well as adverse outcomes, is the presence of severe comorbid variants of the course of HIV infection: HIV and co-infection of chronic viral hepatitis, tuberculosis, HIV and malignant tumors, and HIV-associated neurological diseases. In pediatric practice, the combination of HIV-induced and perinatal CNS lesions is the most relevant. The differential diagnosis of these conditions is complicated due to the polymorphism of clinical manifestations and the possibility of combining several pathological conditions simultaneously in patients. Neuroimaging data does not always have clear criteria for determining the exact cause of cerebral damage. The article presents data of own clinical neuroimaging observations of two patients with perinatal and parenteral HIV infection. The nervous system damage was polyetiological in nature and was presented in one case by a combination of HIV-encephalitis, cerebral toxoplasmosis and CNS lymphoma, in the second by the presence of Bourneville-Pringle disease (tuberous sclerosis) with the formation of giant-cell astrocytoma and HIV-induced brain damage. It should be noted that the optimization of the antiretroviral therapy regimen in the case of a combination of B-cell lymphoma and cerebral toxoplasmosis in a child with perinatal HIV infection led to clinical and laboratory remission

scholarly journals THE EVALUATION OF RISK FACTORS RELATED TO PREVALENCE OF HIV-INFECTION AT DENTIST'S VISIT

2017 ◽  
Vol 23 (5) ◽  
pp. 254-257
Author(s):  
Natalya M. Khelminskaya ◽  
A. V Goncharova ◽  
V. I Kravets ◽  
P. A Shen
Keyword(s):  
Risk Factors ◽  
Oral Cavity ◽  
Hiv Infection ◽  
Clinical Manifestations ◽  
Medical Institutions ◽  
Prevention Of Hiv

The article considers issues of necessity of studying risk factors of spreading of IV-infection at dentist's visit in sate medical institutions and commercial stomatological structures. The data from publications concerning morbidity is presented. The clinical manifestations in oral cavity of patients with HIV-infection are studied. The analysis of efficiency of medical activities is presented. The recommendations concerning prevention of HIV-infection are given.

scholarly journals Systemic lupus erythematosus or lupus-like syndrome in patients with HIV infection: clinical case review

2021 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Margarita A. Gromova ◽  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Hiv Infection ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
High Dose ◽  
Case Review ◽  
Systemic Lupus ◽  
Wide Range

Background. Due to multi-organ lesions and a wide range of clinical manifestations, human immunodeficiency virus (HIV infection) resembles systemic connective tissue diseases, particularly systemic lupus erythematosus (SLE). Similarity of immune disorders in patients with HIV infection and SLE may lead to misdiagnosis resulting in wrong tactics of treatment (prescribing immunosuppressive therapy instead of high-dose antiretroviral therapy). Aim. To report the HIV infection and SLE differential diagnosis challenges. Results. By January 2021, the analysis of national literature revealed two cases of HIV infection in young women, initially misdiagnosed with suspected SLE. In addition to two patients described in literature, one more female patient with SLE manifestations combined with advanced stage of HIV infection was examined. Conclusion. HIV and SLE differential diagnosis is the ultimate challenge for clinicians. Physicians should be especially apprehensive about HIV infection when making the diagnosis of SLE. SLE therapy in patients with HIV infection should be appointed according to strict indications.

scholarly journals Peculiarities of diagnostication and treatment of cases of headache associated with migraine attacks

2015 ◽  
pp. 8-12
Author(s):  
N.K. Svyrydova
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Side Effects ◽  
Chronic Migraine ◽  
Diagnostic Criteria ◽  
Neurological Disorder ◽  
Modifiable Risk Factors ◽  
Level Of Evidence ◽  
Treatment Principles ◽  
The World

Migraine is a frequent neurological disorder that is recorded in 12.6% of the population (6% of men, 18% women). According to the WHO, migraine is on the list of 20 most debilitating diseases in the world. The article outlines the classification, clinical and neurological characteristics and diagnostic criteria of migraine types. The article describes the modifiable risk factors and differential diagnosis of chronic migraine. The article provides the treatment principles of migraine according to the level of evidence of major groups of antimigraine medications and their possible side effects and complications.

scholarly journals IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME IN HIV INFECTION

2018 ◽  
Vol 8 (2) ◽  
pp. 139-149 ◽  
Author(s):  
E. V. Boeva ◽  
N. A. Belyakov
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Clinical Manifestations ◽  
Antiretroviral Drugs ◽  
People Living With Hiv ◽  
Hiv Rna ◽  
Inflammatory Syndrome

Antiretroviral therapy (ART) leads to suppression of HIV replication, contributes to increase in the number of CD4-lymphocytes count and  partial restoration or activation of the immune system. The  consequence is a reduction of incidence of opportunistic diseases,  increase in the duration and quality of life of people living with HIV  (PLHIV). However, in some patients with severe immunosuppression, this may be accompanied by a worsening of the condition and risks  of formation of the immune reconstitution inflammatory syndrome  (IRIS), which manifests itself in the development of new or  previously treated opportunistic, secondary and exacerbating non- infectious diseases against a virologically effective ART. The  frequency of the development of IRIS varies widely, in cases of  tuberculosis-associated manifestation it can reach 50%. Risk factors  for the development of IRIS are low initial CD4-lymphocyte count  and a high load of HIV RNA in the blood, the presence of  opportunistic infections during the initiation of ART. Discussed terminology issues, other possible risk factors for the  development of the syndrome, regularities of the pathological process are considered. Epidemiological statistics of  IRIS, pathogenetic bases, variants of clinical and laboratory  manifestations of complications are given. The criteria for diagnosis  of the syndrome, as well as the necessary conditions for its  occurrence, are considered. Particular attention is paid to the most  common opportunistic infections that cause the manifestation of  IRIS, the peculiarities and polymorphism of clinical manifestations  and the prevention of their occurrence. Currently, there is an  increasing incidence of HIV infection in the late stages. Laboratory  and clinical differences in the manifestations of acquired  immunodeficiency syndrome (AIDS) and IRIS have been sanctified. In view of the blurring of the diagnostic criteria, in the  Russian Federation specialists rarely expose IRIS to clinical or pathological diagnoses, therefore it is rather difficult to trace the  frequency of occurrence of this condition. Clinical and laboratory  manifestations are systematized, which allows to formulate this  diagnosis on the basis of their totality. Prevention of IRIS is the  prudent prescription of antiretroviral drugs. It is neces sary to  conduct a qualitative and timely diagnosis of concomitant diseases of infectious and non-infectious nature before the initiation of ART and  during treatment, the appointment of effective etiotropic therapy for  opportunistic and secon dary infections. In order to improve the  prognosis of HIV infection, preferably early onset of ART with stable  CD4-lym phocyte counts and low HIV RNA levels in the blood.

scholarly journals Contribution to differential diagnosis of sarcoidosis and disseminated tuberculosis

2019 ◽  
Vol 12 (11) ◽  
pp. e230652 ◽  
Author(s):  
Kamille Carstens Hansen ◽  
Søren Jensen-Fangel ◽  
Bo Langhoff Hønge
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Mycobacterium Tuberculosis ◽  
Steroid Treatment ◽  
University Hospital ◽  
Bacillus Calmette Guerin ◽  
Histological Findings ◽  
Latent Tb ◽  
The Right ◽  
Widespread Dissemination

A previously healthy 54-year-old ethnically Danish man was referred to the Department of Infectious Diseases at Aarhus University Hospital after an unexpected detection of Mycobacterium tuberculosis DNA in his lungs. Further examination revealed widespread dissemination of the tuberculosis (TB) to brain, mastoid, urinary and gastrointestinal tract. Thirteen months earlier, the patient was orchiectomised due to recurring inflammation of the right testicle. Three and a half months prior to admission to our department the patient started immunosuppressive therapy with steroids due to radiological and histological findings in the lungs that were interpreted as sarcoidosis (SA). This treatment is likely to be co-responsible for the pronounced dissemination of the TB. The patient was Bacillus Calmette-Guérin (BCG)-vaccinated as a child and had no apparent risk factors for TB apart from travelling in TB-endemic countries until 10 years before falling ill. Screening for latent TB was not performed prior to starting steroid treatment.

scholarly journals Amantadine withdrawal syndrome masquerading as COVID-19 encephalopathy: a case report and review of the literature

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
John P Murray ◽  
Angela Kerins
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Side Effects ◽  
Withdrawal Syndrome ◽  
Clinical Manifestations ◽  
Case Series ◽  
Altered Mental Status ◽  
Review Of The Literature ◽  
Medication Discontinuation ◽  
Hypoactive Delirium

ABSTRACT Amantadine withdrawal syndrome (AWS) is a rare but recognized cause of severe and persistent altered mental status sometimes with co-occurring extrapyramidal symptoms. First described in a case series from 1987, its clinical manifestations have been characterized along a spectrum ranging from profound hypoactive delirium to hyperactive delirium with hallucinations. Risk factors for withdrawal include abrupt medication discontinuation, prolonged use, older age and underlying dementia. Herein we describe a case of a 52-year-old woman who presented with confusion, hallucinations, and coronavirus disease-2019 infection. She subsequently developed a prolonged hypoactive delirium after her amantadine was tapered and held. Her hypoactive delirium entirely resolved with resumption of amantadine confirming the diagnosis of AWS. This case illustrates the importance of slowly tapering dopaminergic medications and being aware of rare pharmacologic side effects.

scholarly journals Features of clinical manifestations and diagnostics of pulmonary tuberculosis and opportunistic lung infections combination in adult patients with advanced HIV infection and immunodeficiency

2020 ◽  
Vol 22 (11) ◽  
pp. 78-86
Author(s):  
Anastasiia V. Mishina ◽  
◽  
Anastasiia V. Mishina ◽  
Vladimir Yu. Mishin ◽  
Vladimir Yu. Mishin ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Hiv Infection ◽  
Clinical Manifestations ◽  
Adult Patients ◽  
Lung Infections ◽  
Microsoft Office

Цель. Изучить особенности клинических проявлений и диагностики сочетания туберкулеза органов дыхания (ТОД) с оппортунистическими инфек-циями легких (ОИЛ) у больных на поздних стадиях ВИЧ-инфекции с иммунодефицитом. Материалы и методы. В исследование включены 338 впервые выявленных больных ТОД с выделением Mycobacterium tuberculosis, в возрасте 25–60 лет, со стадией 4В и 5 ВИЧ-инфекции в фазе прогрессирования и без антиретровирусной терапии, разделенных на 2 группы: 169 пациентов с сочетанием ТОД с ОИЛ (основная группа) и 169 – с ТОД (группа сравнения). Всем больным проводилось клинико-лабораторное, лучевое и брон-хологическое исследование, а для выявления ОИЛ – микробиологическое, иммунологическое, молекулярно-генетическое, цитологическое и гисто-логическое исследование диагностического материала респираторного тракта, спинномозговой и плевральной жидкости, крови, мочи и кала. Статистическая обработка данных проводилась с помощью программы Microsoft Office Excel 2010 с вычислением среднего показателя в группе и стандартной ошибки среднего, доверительного интервала. Результаты. Установлено, что туберкулез у больных основной группы и группы сравнения имел генерализованный характер с множественными поражениями, внелегочными проявлениями, что характеризовалось выраженным синдромом интоксикации, бронхолегочными проявлениями и симптомами поражения других органов и систем. Это не позволяет дифференцировать сочетание ТОД с ОИЛ и с ТОД, и их диагностика возможна только при выявлении M. tuberculosis и этиологии возбудителей других ОИЛ. На компьютерной томограмме органов грудной клетки при одновре-менном сочетании нескольких болезней легких визуализируется синдром диссеминации, синдром аденопатии и синдром патологии легочного ри-сунка, представленный уплотнением интерстициальной ткани по типу «матового стекла». В этих случаях не последнюю роль играло одновременное сочетание ТОД с ОИЛ, а также с наслоением поражений легких непосредственно ВИЧ, что не представляло возможным дифференцировать эти патологии. Различие было возможным только при выявлении M. tuberculosis и этиологии возбудителей других ОИЛ. Заключение. На основании проведенного исследования предложен алгоритм последовательной этиологической диагностики сочетания ТОД с ОИЛ у больных на поздних стадиях ВИЧ-инфекции с иммунодефицитом. Ключевые слова: туберкулез органов дыхания, оппортунистические инфекции легких, поздние стадии ВИЧ-инфекции, микробиологическая ди-агностика, молекулярно-генетическая диагностика, иммунодиагностика, лучевая диагностика. Для цитирования: Мишина А.В., Мишин В.Ю., Эргешов А.Э. и др. Особенности клинических проявлений и диагностики сочетания туберкулеза ор-ганов дыхания с оппортунистическими инфекциями легких у взрослых больных на поздних стадиях ВИЧ-инфекции с иммунодефицитом. Consilium Medicum. 2020; 22 (11): 78–86. DOI: 10.26442/20751753.2020.11.200184

scholarly journals Potensi Ekstrak Curcuma Xanthorrhiza Sebagai Terapi Pendamping Tuberkulosis

2021 ◽  
Author(s):  
Hamzah Haryo Prakoso ◽  
Andre Setiawan ◽  
daffa sadewa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Abdominal Pain ◽  
Side Effects ◽  
Clinical Manifestations ◽  
World Health ◽  
Exclusion Criteria ◽  
Anti Oxidant ◽  
Curcuma Xanthorrhiza ◽  
Anti Inflammatory ◽  
Tuberculosis Activity

Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Most of it attacks the lungs and is still a world health problem. Therapy with a combination of drugs called Anti-Tuberculosis Drugs (OAT) has become a standard and effective cure for TB sufferers as long as it is regular and complete. However, the drawback of OAT is that it has several side effects that allow temporary drug interruption and worsening of clinical manifestations. For that we need companion therapy to overcome this. The purpose of this paper is to search and analyze literature regarding the potential of Curcuma xanthorrhizol extract as a companion therapy for tuberculosis. The method used is by searching the pubmed and google scholar databases with the keywords curcuma xanthorrhiza, curcumin, xanthorrhizol, flavonoids, Mycobacterium tuberculosis, anti-inflammatory, anti-oxidant, gastroprotective and anti-bacterial. Then the literature is selected based on inclusion and exclusion criteria. The results and discussion obtained were that curcuma xanthorrhiza has various active compounds that are useful for preventing side effects of OAT such as curcumin, xanthorrhizol, and flavonoids. Curcuma xanthorrhiza can be used as anti-inflammatory, anti-oxidant, gastroprotective so that side effects such as skin rashes, nausea, vomiting, abdominal pain and others can be prevented. Besides that, curcumin content in Curcuma xanthorrhiza has anti-tuberculosis activity. The conclusion is that curcuma xanthorrhiza extract can be considered as a companion drug for TB patients. It can be done further research on the potential of ginger

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