Document 0745
 DOCN  M9480745
 TI    The acquired immune deficiency syndrome: an overview for the emergency
       physician, Part 1.
 DT    9410
 AU    Guss DA; University of California, San Diego Medical Center 92103-8676.
 SO    J Emerg Med. 1994 May-Jun;12(3):375-84. Unique Identifier : AIDSLINE
       MED/94315271
 AB    The acquired immune deficiency syndrome (AIDS) was recognized as a
       distinct entity in 1981. It began as a medical curiosity affecting only
       several dozen individuals in a restricted segment of the U.S.
       population. In the 12 years since its description, AIDS has become a
       pandemic affecting tens of millions with cases reported from all major
       countries. The illness is caused by a retrovirus, termed human
       immunodeficiency virus (HIV). It is a blood-borne disease with sexual,
       parenteral, and perinatal modes of transmission. Infection with the
       virus can be determined by a number of serologic techniques as well as
       viral culture. The pathophysiology of illness is incompletely
       understood, but is in large part related to destruction of helper, CD4
       lymphocytes. This results in immune dysfunction and the development of a
       variety of opportunistic infections and malignancies. A great deal has
       been learned over the last decade, with important advances in treatment.
       Zidovudine (AZT) remains the most important agent in slowing progression
       of the disease and has resulted in prolonging survival. All organ
       systems can be affected by HIV, and many clinical manifestations are
       protein. Fever, weight loss, and diarrhea are often encountered general
       symptoms. The skin is frequently involved, with Kaposi's Sarcoma the
       most common malignancy and a variety of fungi and viruses the most
       frequent cause of infection. The lung is involved in the majority of
       patients, with Pneumocystis Carinii (PCP) and mycobacteria emerging as
       the most important pathogens. A variety of treatments have demonstrated
       efficacy for PCP. The risk of PCP is related to the decay in CD4
       lymphocytes so that prophylactic treatment is recommended when CD4
       counts fall below 200. Mycobacterial infection with multiresistant
       organisms has complicated the management of these infections and poses
       new risks to health care workers. Part 1 of this two-part series on AIDS
       discusses the pathophysiology and clinical expression, epidemiology,
       laboratory testing, and the general clinical manifestations of AIDS, as
       well as dermatologic, pulmonary, and cardiac symptoms. Part 2 will
       discuss the gastrointestinal, neurologic, and ocular symptoms, as well
       as the treatment and management of the AIDS patient.
 DE    *Acquired Immunodeficiency Syndrome/DIAGNOSIS/DRUG THERAPY/
       EPIDEMIOLOGY/PHYSIOPATHOLOGY  *Emergency Medicine  Human  JOURNAL
       ARTICLE  REVIEW  REVIEW, TUTORIAL

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       protected by Copyright Law (Title 17, U.S.Code).