home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Shareware Overload Trio 2
/
Shareware Overload Trio Volume 2 (Chestnut CD-ROM).ISO
/
dir26
/
med9410o.zip
/
M94A2887.TXT
< prev
next >
Wrap
Text File
|
1994-10-25
|
3KB
|
46 lines
Document 2887
DOCN M94A2887
TI A survey of adult meningitis in Zimbabwe.
DT 9412
AU Malin A; Bwakura T; Robertson V; Musvaire P; University of Zimbabwe
Medical School, Harare.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):202 (abstract no. PB0236). Unique
Identifier : AIDSLINE ICA10/94369688
AB OBJECTIVE: (1) To survey all types of adult meningitis. (2) To identify
clinical and laboratory markers which distinguish types of meningitis as
an aid to diagnosis in developing countries. METHODS: Blood, CSF
(cerebrospinal fluid) and clinical data were collected prospectively
from unselected, consecutive adults admitted to a central hospital in
Zimbabwe over a 6 month period. Standard microbiology, biochemistry, HIV
testing, CD4 phenotyping, and antigen testing (Cryptococcus neoformans,
Pneumococcus, Meningococcus and H influenzae) were performed. RESULTS:
Meningitis was demonstrated in 65 cases; 82% were HIV-positive and 80%
were male. Cases were divided as follows: C neoformans 52%, Pneumococcus
23% and M tuberculosis (TB) 25%. HIV positivity rates were 100%, 53% and
88% respectively. Mean CD4 counts in HIV positive cases were 144
microliters, 116 microliters and 275 microliters respectively.
Distinguishing characteristics included: (1) a CSF pleocytosis,
invariable in all cases of TB and Pneumococcus, but absent in 44% of
cryptococcal cases (p < 0.002), (2) neck stiffness, absent in 26% of
cryptococcal, 6% of TB and 0% of pneumococcal cases (p < 0.003), and (3)
confusion, rare in pneumococcal cases (7%) but common with cryptococcal
cases (44%) and TB cases (56%) (p < 0.006). CONCLUSIONS: Adult
meningitis was strongly associated with HIV infection. The pathogens
identified reflect those seen in African AIDS. Signs of meningism, CSF
inflammatory changes and India Ink staining were often absent in
cryptococcal meningitis and clinical features were limited to fever and
headache. An algorithmic approach to management with simple tests is
possible but antigen testing would greatly assist diagnosis in equivocal
cases.
DE Adult Biological Markers/BLOOD/CEREBROSPINAL FLUID Cerebrospinal
Fluid/CYTOLOGY Comorbidity Dyes Female Human HIV
Infections/EPIDEMIOLOGY Male Meningitis/BLOOD/CEREBROSPINAL
FLUID/COMPLICATIONS/DIAGNOSIS/ *EPIDEMIOLOGY Meningitis,
Cryptococcal/EPIDEMIOLOGY Meningitis, Pneumococcal/EPIDEMIOLOGY Stains
and Staining Tuberculosis, Meningeal/EPIDEMIOLOGY
Zimbabwe/EPIDEMIOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).