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1994-08-27
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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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).