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M94A2894.TXT
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1994-10-25
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Document 2894
DOCN M94A2894
TI Persistent neutrophilic meningitis in patients with AIDS.
DT 9412
AU Roca V; Sanchez-Portocarrero J; Martin T; Perez-Cecilia E; de la Torre
F; Picazo JJ; Fernandez-Cruz A; Hospital Universitario San Carlos,
Madrid, Spain.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):200 (abstract no. PB0230). Unique
Identifier : AIDSLINE ICA10/94369681
AB We report five cases of Persistent Neutrophilic Meningitis (PNM),
diagnosed in base of case-definition criteria proposed by J. E. Peacock
(persistent neutrophilic pleocytosis in CSF for more than 7 days,
despite to be treated with appropriate antimicrobial regime), and
accounted in patients with HIV-infection. In 4 the responsible
etiological microorganism of PNM was M. tuberculosis and one it was C.
albicans. All were parenteral drug addicts (4 man y 1 women) with
severely impaired immunity: CD4+ lymphocyte count were below of 100 by
milliliter in four of them. Three of four patients with M. tuberculosis
meningitis had been previously diagnosed and incompletely treated (due
to self-discontinuation) with 4 drugs (isoniazid, rifampin, ethambutol
and pyrazinamide) for an episode of pulmonary or disseminated
tuberculosis. Headache was the more constant symptom, present in all.
Fever was present in only 4, stiff neck in 3/5, CT alterations in 3/5,
nausea and or vomiting in 2/5, obnubilation or cognitive impairment 2/5
and another infection of central nervous system (toxoplasmosis) in 1/5.
So, we think that the concept of PNM is a good predictor of etiological
responsible agent of meningitis, and, in our geographic area, is closely
and more frequently related, in HIV-positive patients, with M.
tuberculosis.
DE Antitubercular Agents/THERAPEUTIC USE AIDS-Related Opportunistic
Infections/DRUG THERAPY/*PATHOLOGY Candidiasis/DRUG THERAPY/*PATHOLOGY
Female Human Leukocyte Count Male Meningitis, Fungal/DRUG
THERAPY/*PATHOLOGY *Neutrophils Substance Abuse,
Intravenous/COMPLICATIONS Tuberculosis, Meningeal/DRUG
THERAPY/*PATHOLOGY T4 Lymphocytes MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).