Multiple atypical presentations of acute retroviral syndromehave been reported in the literature, but rarely has acute retroviralsyndrome been associated with disseminated intravascularcoagulation (DIC). We detail a case of a 19-year-old manadmitted to the hospital with initially unexplained severe DICthat on workup was found to be secondary to acute retroviralsyndrome. [Infect Med. 2008;25:24-28]
The incidence of cryptococcal infections in the HIV-infectedpopulation has diminished because of the effectiveness of anti retroviraltherapy, whereas the incidence in non–HIV-infectedhosts has grown. Despite improvements in antifungal therapy,successful outcomes in the management of cryptococcalmeningitis are dependent on a high index of clinical suspicion,appropriate use of diagnostic assays, early and aggressiveantifungal therapy, and recognition of complications such asincreased intracranial pressure and immune reconstitutionsyndromes. Published guidelines for the care of patients withcryptococcal meningitis are available and may be adapted toindividual patient requirements. Basic and clinical studies areneeded to further define the components of immune protection,optimal therapy in special patient populations, and the recognitionand treatment of complications of cryptococcal meningitis.[Infect Med. 2008;25:11-23]
In patients with HIV/AIDS, multifocal choroiditis has been associated with numerous life-threatening disseminated opportunistic infections. Optic neuropathy in patients with AIDS is also associated with opportunistic infection.
A 55-year-old man was admitted after presenting to the hospital emergency department with short-term memory loss and headache and a 1-month history of intermittent fevers, weight loss, and chills.
Human herpesvirus 8 (HHV8) is associated with Kaposi sarcoma (KS) and 4 lymphoproliferative disorders: multicentric Castleman disease, primary effusion lymphoma, B-cell plasmablastic lymphoma, and germinotrophic lymphoproliferative disorder.
Breathable indoor air has become so commonplace in the United States (and, increasingly, worldwide) that many forget that it has been less than a quarter century since the major push to limit indoor smoking really began to have an impact.
This gay white man was your patient several years ago. He originally presented to you in 1995 with diffuse cutaneous Kaposi sarcoma (KS) and a CD4+ cell count of 15/µL.
Trimeris and its partner Roche said they are withdrawing an application to sell their injectable AIDS drug Fuzeon (enfuvirtide) in a needle-free device. "While the device has shown potential benefit for some patients, we don't believe it's the real alternative delivery option for all patients," said Michelle Zupancic, vice president, HIV, at Roche (Vollmer S. News & Observer [Raleigh]. October 4, 2007).
In 1985, only 7% of AIDS cases occurred among female adults and adolescents older than 13 years, but by 2005, they represented 27% of US AIDS cases.
Blowing bubbles is an effective way to gain a young patient's attention.
Despite meticulous titration of anticoagulation therapy and careful attention to confounding medications, serious bleeding complications occur in some patients who receive warfarin.
Some of my patients who are being treated for hypertension, hyperlipidemia, or both claim that an elevated blood pressure reading or lipid level measurement resulted from a sodium- or fat-laden meal that they had eaten 1 or 2 days before their office visit.
For easier application of eye ointment, have the patient lie down or sit with his head tilted back.
The differential diagnosis of generalized weakness is enormous; it includes disorders at all levels of the neur-axis. A variety of electrophysiological, pathological, radiographic, and other laboratory studies may be indicated depending on the specific diagnostic possibilities; costs can be controlled if such investigations are selected judiciously.
A 50-year-old woman had a 6-month history of severe generalized itchiness and fatigability. There was no associated fever, abdominal pain, or joint pain. A cholecystectomy had been performed 20 years earlier. She had no family history of hypercholesterolemia or liver disease.
Identifying the cause of a persistent, asymptomatic aminotransferase elevation can be challenging. The possible diagnoses are many and varied. To narrow the differential, begin with a detailed history.
Sometimes, despite compliance with prescribed thyroid medication, a patient's thyroid-stimulating hormone (TSH) level remains high.
The notoriously adaptable and increasingly common pathogen requires a new approach including routine I&D and culturing of infected tissues; the use of more-potent antibiotics, but only when needed; and a focus on hygiene in patients with recurrent infections.
An epidemic of acute hepatitis C is emerging among HIV-infected men who have sex with men (MSM), with a growing number of cases reported in the MSM population in the United States and Europe.
We present the case of a 55-year-old man with AIDS who had disseminated Mycobacterium avium-intracellulare (MAI) infection who was nonadherent to antiretroviral treatment and prophylaxis for opportunistic infections.
