- Atypical presentation and diagnosis of AIDS-related CMV encephalitis. [Case Reports]BMJ Case Rep. 2022 Aug 30; 15(8)BC
- We report a case of man in his 40s with a medical history of post-traumatic stress disorder who presented to the emergency department with altered mental status, ataxia, headache and dizziness a few hours after snorting amphetamines and mushrooms. Twenty-four hours after presentation, while no longer abusing amphetamines or mushrooms, he remained ataxic and dizzy. A CT scan of the head showed per…
- Publisher Full Text (DOI)
- Outpatient Cryptococcal Antigen Screening is Associated with Favorable Baseline Characteristics and Improved Survival in Persons with Cryptococcal Meningitis in Uganda. [Journal Article]Clin Infect Dis. 2022 Jul 21 [Online ahead of print]CI
- CONCLUSIONS: Survival from cryptococcal meningitis was higher in persons with prior CrAg screening than those without CrAg screening. Altered mental status was the most potent predictor for mortality in a multivariate model. We suggest that CrAg screening detects cryptococcal meningitis at an earlier stage, as evidenced by a favorable baseline risk profile and notably fewer persons with altered mental status.
- Publisher Full Text (DOI)
- A case report of a brain herniation secondary to cryptococcal meningitis with elevated intracranial pressure in a patient with Human Immunodeficiency Virus/Acquired immunodeficiency syndrome (HIV/AIDS). [Case Reports]
- CONCLUSIONS: This case highlights the importance of aggressive management of elevated intracranial pressure in cryptococcal meningitis. It reiterates the need for more data regarding the optimal timing and frequency of therapeutic lumbar puncture and the use of temporary lumbar drainage catheters and ventriculostomy to manage this potentially fatal complication.
- PMC Free PDF
- Strongyloides stercoralis hyperinfection syndrome: a known entity in an unknown provenance. [Case Reports]BMJ Case Rep. 2022 Apr 11; 15(4)BC
- A 49-year-old man was admitted with altered mental status, high-grade fevers, tachycardia and leucocytosis. Cerebrospinal fluid (CSF) was purulent with a markedly elevated nucleated cell count with neutrophilic predominance, elevated protein and low glucose. CSF gram stain was negative. Patient received vancomycin, cefepime, ampicillin and acyclovir for presumed meningitis. He was intubated for p…
- Publisher Full Text (DOI)
- Shigella Bacteremia in an Immunocompetent Patient. [Case Reports]
- Isolation of Shigella in the bloodstream is a rare sequela of Shigella infections. Shigellemia typically occurs in patients with immature immune responses or in immunocompromised adults. Herein, we present a case of shigellemia in a 40-year-old male who presented with diabetic ketoacidosis (DKA), severe diarrhea, hypovolemic hyponatremia, and altered mental status. Stool cultures were found to be…
- PMC Free PDF
- Bilateral Cranial Nerve VI Palsies in Cryptococcal Meningitis, HIV, and Syphilis: A Case Report. [Journal Article]
- CONCLUSIONS: Cryptococcal meningitis remains a life-threatening complication of HIV/AIDS. Coinfections with HIV, particularly syphilis, further complicate a patient's prognosis as both can lead to devastating neurological sequelae. In cryptococcal meningitis, elevated intracranial pressure is a complication that can manifest as seizures, altered mental status, and cranial nerve palsies.
- PMC Free PDF
- Treatment of Elsberg Syndrome Causes Fever of Unknown Origin Attributable to Drug Reaction. [Case Reports]
- A 56-year-old male with a history of non-adherence to HIV anti-retroviral therapy (ART) presented with Elsberg syndrome - varicella reactivation causing fever, painful dermatomal rash, weakness of bilateral lower extremities, and urinary and bowel dysfunction. On the third day of hospitalization, the patient developed altered mental status. An investigation for encephalitis and myelitis revealed …
- PMC Free PDF
- Preserved central nervous system functioning after use of romidepsin as a latency-reversing agent in an HIV cure strategy. [Clinical Trial]
- CONCLUSIONS: No detrimental effects on cognitive status, functional outcomes, or brain imaging parameters were observed after using the HDACi RMD as latency-reversing agent with the MVA.HIVconsv vaccine in early-treated HIV-1-infected individuals. CNS safety was also confirmed after completion of the MAP.
- Publisher Full Text (DOI)
- Assessing combinatorial effects of HIV infection and former cocaine dependence on cognitive control processes: A functional neuroimaging study of response inhibition. [Journal Article]
- Individuals with a diagnosis of co-morbid HIV infection and cocaine use disorder are at higher risk of poor health outcomes. Active cocaine users, both with and without HIV infection, show clear deficits in response inhibition and other measures of executive function that are instrumental in maintaining drug abstinence, factors that may complicate treatment. Neuroimaging and behavioral evidence i…
- Publisher Full Text (DOI)
- Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV. [Journal Article]
- CONCLUSIONS: Whilst we found no evidence of either detrimental or beneficial effects of ABC, FTC and TFV plasma exposure on cognitive function of PWH, higher plasma 3TC exposures were generally associated with better cognitive performance although higher peak concentrations were associated with poorer performance.
- PMC Free PDF
- Targeting interventions for HIV testing and treatment uptake: An attitudinal and behavioural segmentation of men aged 20-34 in KwaZulu-Natal and Mpumalanga, South Africa. [Multicenter Study]
- Despite recent improvements, men still have worse HIV outcomes than women in South Africa. This study describes how young men form distinct behavioural and attitudinal subgroups, and is intended to inform the design of targeted interventions to encourage HIV testing and initiation on antiretroviral therapy. Data were collected using a cross-sectional survey with questions on men's attitudes, beli…
- PMC Free PDF
- Successful Utilization of Levodopa in HIV-Induced Parkinsonism. [Case Reports]
- We report a case of a 63-year-old African American female patient with a past medical history of treatment naïve human immunodeficiency virus (HIV). She was referred to our hospital with altered mental status and rigidity with a history of progressive ambulation difficulties and decreased verbal output over the previous months as reported by her son. Her clinical presentation and brain MRI were c…
- PMC Free PDF
- Impact of biological sex on cryptococcal meningitis mortality in Uganda and South Africa. [Journal Article]
- The role of biological sex on clinical outcomes and the pathogenesis of AIDS-related opportunistic infections is unknown. We assessed baseline biomarkers and outcomes between 577 men and 400 women in HIV-related cryptococcal meningitis cohorts in Uganda and South Africa from 2010 to 2017. We compared 10-week mortality by sex via Cox proportional hazards models. The 10-week mortality for women was…
- PMC Free PDF
- Fatal disseminated Mycobacterium haemophilum infection involving the central nervous system in a renal transplant recipient. [Journal Article]
- Mycobacterium haemophilum is a slow growing nontuberculous mycobacterium which prefers cooler temperatures and requires iron for growth. It usually causes skin and soft tissue infections in immunocompromised hosts and cervical lymphadenitis in healthy children. We present the case of fatal disseminated M. haemophilum in an immunocompromised host with central nervous system (CNS) involvement. Our …
- PMC Free PDF
- Neurocognitive evaluation using the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment Test (MoCA) in an HIV-2 population. [Journal Article]
- CONCLUSIONS: Neurocognitive impairment (both scales altered) was present in 35.8%, which is comparable to what is described for HIV-1. The MoCA performed worse in the migrant population and might not be applicable in this setting.
- Publisher Full Text (DOI)
- Safety of Gabapentin Prescribed for Any Indication in a Large Clinical Cohort of 571,718 US Veterans with and without Alcohol Use Disorder. [Journal Article]
- CONCLUSIONS: Gabapentin is associated with falls or fractures and altered mental status. Clinicians should be monitoring gabapentin safety, especially at doses ≥ 600 mg/d, in patients with and without AUD.
- PMC Free PDF
- Meningomyeloencephalitis secondary to Mycobacterium haemophilum infection in AIDS. [Case Reports]
- Infections by opportunistic non-tuberculous mycobacteria (NTM) are rising in global incidence. One emerging, slowly growing NTM is Mycobacterium haemophilum, which can cause skin, lung, bone, and soft tissue infections in immunocompromised patients as well as lymphadenitis in immunocompetent individuals. Detection of this microorganism is difficult using conventional culture-based methods and few…
- PMC Free PDF
- Self-reported depression and social support are associated with egocentric network characteristics of HIV-infected women of color. [Journal Article]
- CONCLUSIONS: We found that both functional and structural social network characteristics contributed to perceptions of support by HIV-infected WOC.
- PMC Free PDF
- Linkage to Care Following an HIV Diagnosis in Three Public Sector Clinics in eThekwini (Durban), South Africa: Findings from a Prospective Cohort Study. [Journal Article]
- Linkage to care following an HIV diagnosis remains an important HIV care continuum milestone, even in the era of universal ART eligibility. In an 8-month prospective cohort study among 459 (309 women, 150 men) newly-diagnosed HIV-positive individuals in three public-sector clinics in Durban metropolitan region, South Africa, from 2010 to 2013, median time to return to clinic for CD4+ results (lin…
- Publisher Full Text (DOI)
- Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis. [Case Reports]
- CONCLUSIONS: This case illustrates the importance of including GAE into the differential diagnosis of brain mass. We advocate early molecular testing of tissue specimen by the CDC to achieve an appropriate diagnosis, and a multidisciplinary approach for the management of this condition.
- Publisher Full Text (DOI)
- Mapping abnormal subcortical neurodevelopment in a cohort of Thai children with HIV. [Journal Article]
- Alterations in subcortical brain structures have been reported in adults with HIV and, to a lesser extent, pediatric cohorts. The extent of longitudinal structural abnormalities in children with perinatal HIV infection (PaHIV) remains unclear. We modeled subcortical morphometry from whole brain structural magnetic resonance imaging (1.5 T) scans of 43 Thai children with PaHIV (baseline age = 11.0…
- PMC Free PDF
- Anxiety symptoms and felt stigma among young people living with perinatally or behaviourally-acquired HIV in Ukraine: A cross-sectional survey. [Journal Article]
- CONCLUSIONS: Results indicated unmet need for psychosocial support. Further work is needed to explore strategies for mental health support, particularly around disclosure, self-esteem and stigma.
- PMC Free PDF
- Severe hypercalcemia in a patient with extrapulmonary Mycobacterium abscessus: granuloma or immune reconstitution inflammatory syndrome? First case of Mycobacterium abscessus presenting as retroperitoneal lymphadenopathy with severe hypercalcemia: a case report and literature review. [Review]
- Background: Nontuberculous mycobacterium is a recognized cause of hypercalcemia, particularly in patients with acquired immunodeficiency syndrome (AIDS). Here we describe a case of severe hypercalcemia secondary to Mycobacterium abscessus (M. abscessus) in a patient with AIDS. To the best of our knowledge this is the first case report describing a case of M. abscessus presenting as retroperitonea…
- PMC Free PDF
- AMBIsome Therapy Induction OptimisatioN (AMBITION): High Dose AmBisome for Cryptococcal Meningitis Induction Therapy in sub-Saharan Africa: Study Protocol for a Phase 3 Randomised Controlled Non-Inferiority Trial. [Journal Article]
- CONCLUSIONS: A safe, sustainable and easy to administer regimen of L-AmB that is non-inferior to seven days of daily amphotericin B deoxycholate therapy may reduce the number of adverse events seen in patients treated with amphotericin B deoxycholate and shorten hospital admissions, providing a highly favourable and implementable alternative to the current WHO recommended first-line treatment.
- PMC Free PDF
- Factors associated with social deprivation among older persons living with HIV. [Journal Article]
- Aging persons living with HIV may develop multiple health problems, including comorbidities, and altered physical and mental health, earlier than non-infected people. They may also experience social deprivation. We assessed the prevalence of social deprivation and its relationship with health indicators in older persons living with HIV. An 18-month, multicenter, cross-sectional study was carried …
- Publisher Full Text (DOI)
- HIV-Associated Cryptococcal Meningitis Occurring at Relatively Higher CD4 Counts. [Journal Article]
- CONCLUSIONS: HIV-infected individuals developing cryptococcal meningitis with CD4 ≥100 cells/μL presented more frequently with altered mental status despite having 10-fold lower fungal burden and with greater Th2 (IL-13) immune response. Higher CD4 count was protective despite an increased propensity for immune-mediated damage, consistent with damage-response framework.
- PMC Free PDF
- HHV-8-associated haemophagocytic lymphohistiocytosis in a patient with advanced AIDS. [Case Reports]
- We present a patient with advanced AIDS admitted with recurrent shock of unclear aetiology, fevers, altered mental status and refractory cytopenias. His case posed a diagnostic challenge because evaluation of septic shock in the setting of advanced AIDS requires a time-consuming work-up for broad infectious aetiologies that can delay consideration of other diagnoses, including primary or secondar…
- PMC Free PDF
- Cryptococcal cerebellitis in no-VIH patient. [Case Reports]
- CONCLUSIONS: The cryptococcosis has different presentations, it´s a disease whose incidence has been increasing since the advent of the HIV / AIDS pandemy, however the commitment of the encephalic parenchyma and in particular the cerebellum is considered rare. In this way we are facing the first case of cryptococcal cerebellitis in our midst.
- PMC Free PDF
- New Diagnosis of AIDS Based on Salmonella enterica subsp. I (enterica) Enteritidis (A) Meningitis in a Previously Immunocompetent Adult in the United States. [Case Reports]
- Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic …
- PMC Free PDF
- Burden Among Caregivers of Children Living with Human Immunodeficiency Virus in North India. [Journal Article]
- CONCLUSIONS: Caring of children is a universal practice but there is a need of special care for children living with HIV. The majority of caregivers who were usually the mothers perceived the burden and need to be assisted in caring for the child. Stigma and discrimination with HIV infection further increased the burden as caregivers did not disclose the HIV status to any near and dear one.
- PMC Free PDF