Presentation
Clinically, the onset of CM is usually insidious, symptoms and signs may be subtle and non-specific. [18] Headache, which is a symptom of overt brain dysfunction and meningitis [19] was the most prominent clinical presentation, present in 97.3% of our [najms.org]
One of them also had altered sensorium at presentation. [neurologyindia.com]
Clinical presentation of meningitis may include: [ 2 ] Fever, headache. [patient.info]
[…] of recent antibiotic use in patients presenting with meningitis. [infectiousdiseaseadvisor.com]
In the present case, the patient was a neurologically impaired woman with HIV/AIDS who was found to have a brain mass in a CT scan of the head. [path.upmc.edu]
Entire Body System
- Fever
Symptoms in mild cases of encephalitis usually include: fever headache poor appetite loss of energy a general sick feeling Serious cases of encephalitis can cause: a high fever severe headache nausea and vomiting stiff neck confusion personality changes [kidshealth.org]
The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Most cases of meningitis in the United States are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. [mayoclinic.org]
Amphotericin B has many side effects including kidney damage, high fever, low blood pressure, decreased numbers of red or white blood cells, nausea, vomiting and chills. [aidsinfo.nih.gov]
Clinical presentation of meningitis may include: [ 2 ] Fever, headache. [patient.info]
The classic symptoms of meningitis are fever, headache and neck stiffness. Prompt diagnosis and treatment of bacterial meningitis and the associated condition of meningococcal septicaemia are vital for a good outcome and recovery. [health24.com]
- Weight Loss
If you have a low CD4 count, keep eep a record of your symptoms, and pay attention to: Fever for more than 2 days Weight loss A change in vision Problems with your mouth, skin, or breathing Call your doctor when you have new or unusual symptoms. [webmd.com]
loss) PML Rapid neurologic decline (hemiplegia, visual field defects, ataxia, aphasia) HIV Encephalopathy Progressive memory loss, depression, movement disorders CMV encephalitis Confusion, focal deficits Laboratory tests Blood : Anti-toxoplasma IgG [learningradiology.com]
Abdominal or rectal pain, nausea, vomiting, diarrhea, intestinal bleeding, malabsorption, weight loss if direct involvement Tends to occur in patients with advanced HIV infection (i.e., CD4 count < 200 per mm 3 ) Endoscopy with biopsy — Extraluminal [aafp.org]
At admission, physical examination revealed fever (38 °C), tachycardia (102 beats/min) and weight loss (approximately 10 kg in the last three months). Respiratory and cardiovascular systems were normal. Abdomen examination was also normal. [elsevier.es]
Majority of patients have a general signs of TB infection (night sweat seen in 80%, weight loss in 76%). Pulmonary symptoms were rarely presenting the symptoms (30%) of cases. [elynsgroup.com]
- Acutely Ill Patient
Prognosis Meningitis kills more UK children under the age of 5 than any other infectious disease. [ 2 ] Prognosis depends on the pathogen, the patient's age and condition and the severity of acute illness. [patient.info]
- Amyloidosis
Amyloidosis senile;Anaphylactic reaction;Anaphylactic shock;Anaphylactic transfusion reaction;Anaphylactoid reaction;Anaphylactoid shock;Anaphylactoid syndrome of pregnancy;Angioedema;Angiopathic neuropathy;Ankylosing spondylitis;Anosmia;Antiacetylcholine [koronarealistit.com]
Neurologic
- Seizure
Seizure anoxic;Seizure cluster;Seizure like phenomena;Seizure prophylaxis;Sensation of foreign body;Septic embolus;Septic pulmonary embolism;Severe acute respiratory syndrome;Severe myoclonic epilepsy of infancy;Shock;Shock symptom;Shrinking lung syndrome [koronarealistit.com]
Seizures: occur more commonly during the acute stage of the disease. [patient.info]
Anticonvulsants might be given to a child having seizures. Over-the-counter (OTC) medicines, like acetaminophen, can help with fever and headaches. Antibiotics don't work against viruses, so aren't used to treat most forms of encephalitis. [kidshealth.org]
The clinical course in both cases was most consistent with Alpers-Huttenlocher syndrome, given the intractable seizures, developmental regression, and, ultimately, death due to liver and renal failure. [hhv-6foundation.org]
The longer you or your child has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including: Hearing loss Memory difficulty Learning disabilities Brain damage Gait problems Seizures Kidney failure Shock [mayoclinic.org]
- Confusion
Primary CNS Lymphoma (EBV) 30% of all brain lesions in AIDS patients (PML, HIV-associated encephalopathy, and CMV encephalitis usually do not cause mass lesions) History Toxo Headache, confusion, +/- fever; focal weakness, seizures; if advanced, dull [learningradiology.com]
The first signs of meningitis include fever, fatigue, a stiff neck, headache, nausea and vomiting, confusion, blurred vision or sensitivity to bright light. The symptoms may come on slowly. [aidsinfonet.org]
Cryptococcal meningitis may cause a person to become confused and have memory loss. Family members or friends may note small changes in personality or behavior. [aidsinfo.nih.gov]
Possible signs and symptoms in anyone older than the age of 2 include: Sudden high fever Stiff neck Severe headache that seems different than normal Headache with nausea or vomiting Confusion or difficulty concentrating Seizures Sleepiness or difficulty [mayoclinic.org]
Within a few days to a few weeks of contact, an infected person may develop the following symptoms: headache nausea vomiting mental changes, including confusion, hallucinations, and personality changes lethargy sensitivity to light In some cases, the [healthline.com]
- Altered Mental Status
Meningitis is distinct from encephalitis, which is inflammation of the brain parenchyma and is strongly associated with altered mental status. [infectiousdiseaseadvisor.com]
In investigating symptoms such as headache, altered mental status, and cranial neuropathy, aseptic meningitis must be a diagnosis of exclusion. [hivinsite.ucsf.edu]
During the hospitalization he presented symptoms consistent with gradually increasing intracranial pressure such as headache and altered mental status that required multiple lumbar punctures to reduce intracranial hypertension (30–45 cm H 2 O). [elsevier.es]
Altered mental state, unconsciousness, toxic/moribund state. Shock: signs of shock include tachycardia and/or hypotension, respiratory distress, altered mental state and poor urine output. [patient.info]
Patients with meningitis or encephalitis generally present with one or more of the following: fever, headache, neck pain or stiffness, altered mental status, or seizure. [aafp.org]
- Neck Stiffness
Stiff neck (generally not present in children under the age of one year or in patients with altered mental state), back rigidity, bulging fontanelle (in infants), photophobia, opisthotonus (if severe). [patient.info]
Her neck was stiff and rigid. Kernig’s and Brudzinski’s signs were present. Lungs were clear with normal heart sounds. On examination of the abdomen, her liver and spleen were not palpable. She had no skin rash or palpable lymph nodes. [pubs.sciepub.com]
The classic symptoms of meningitis are fever, headache and neck stiffness. Prompt diagnosis and treatment of bacterial meningitis and the associated condition of meningococcal septicaemia are vital for a good outcome and recovery. [health24.com]
The key physical exam findings of aseptic meningitis may include fever, nuchal rigidity (neck stiffness) and photophobia. Altered mental status is rare and if present should increase suspicion for acute purulent meningitis or encephalitis. [infectiousdiseaseadvisor.com]
Patients with CM may present with fever as well as symptoms and signs related to inflamed meninges (including neck stiffness), raised intracranial pressure (including headache, confusion, altered level of consciousness, sixth cranial nerve palsies with [sajhivmed.org.za]
- Apathy
While there is some individual variation, frequent manifestations include: inattention and reduced concentration, apathy and dulling of personality, psychomotor slowing, marked motor slowing and ataxia. [radiopaedia.org]
Workup
DISCUSSION Patients with HIV/AIDS frequently present with neurological signs and symptoms and require neuroimaging studies as part of their diagnostic workup. [path.upmc.edu]
So,it seems that in patients with HIV infection, a high index of suspicion with full laboratory workup and early institution of treatment is required to improve survival. ~ Acknowledgement We are thankful to Dr.H.C.Gugnani, Professor Department of Medical [ijmm.org]
Treatment
Treatment of cryptococcal meningitis in KwaZulu-Natal, South Africa. [aidshivresearch.com]
Twelve patients (40%) died while undergoing treatment in the hospital; six during first week of treatment, three each during the second and third weeks of treatment. [omicsonline.org]
[…] a paucity of diagnostic and treatment tools. [edctp.org]
The risks, benefits and alternative to fluconazole treatment (i.e. [sajhivmed.org.za]
The largest prospective study of AIDS-associated cryptococcal meningitis found no difference in outcome between treatment with amphotericin B (0.4 mg per kilogram per day) and treatment with fluconazole, with negative cerebrospinal fluid cultures in less [nejm.org]
Prognosis
Treatment and prognosis Severity is related to the patient's viral load, and can regress with highly active antiretroviral therapy (HAART). Superimposed infection may lead to fulminant disease. [radiopaedia.org]
We also contributed in a review on the long-term prognosis of CM and finally in an advocacy paper for CM to be recognised as a neglected tropical disease. [theses.fr]
Prognosis Meningitis kills more UK children under the age of 5 than any other infectious disease. [ 2 ] Prognosis depends on the pathogen, the patient's age and condition and the severity of acute illness. [patient.info]
Favorable prognosis of purulent meningitis in patients infected with human immunodeficiency virus. Clin Infect Dis;27:176-180, 1998. Molyneux EM et al. The effect of HIV infection on paediatric bacterial meningitis in Blantyre, Malawi. Arch. Dis. [aidsmap.com]
With effective antiretroviral therapy, the prognosis for those who develop PML has improved dramatically, with long-term remission being fairly common. [hivinsite.ucsf.edu]
Etiology
Other well known infectious etiologies of focal brain lesions in HIV/AIDS patients are fungal organisms, CNS tuberculosis and neurosyphilis (12). [path.upmc.edu]
Aseptic Meningitis Clinical Trial The main objective of this study is: - to establish etiology of acute aseptic meningitis/meningoencephalitis in Slovenia - to assess the clinical course and outcome of tick-born... [patientwing.com]
CSF analysis facilitates the diagnosis of specific HIV-related etiologies and the assessment of other non–HIV-associated causes. [emedicine.medscape.com]
A NINDS study found HHV-6 DNA in the CSF of 40% of 35 immunocompetent patients with encephalitis of unknown etiology ( Yao 2009 ). HHV-6 encephalitis/encephalopathy associated with primary infection in infants has an unexpectedly poor outcome. [hhv-6foundation.org]
Besides HIV, other etiologies of mononeuropathy multiplex include hepatitis B infection, diabetes, herpes zoster, and neoplastic infiltration of nerve. [hivinsite.ucsf.edu]
Epidemiology
The work includes considerable emphasis onthe epidemiology, psychological and psychiatric aspects of the disease complex. [books.google.com]
AIDS-associated cryptococcal meningitis in Rwanda (1983–1992): epidemiologic and diagnostic features. J Infect; 39:32–37, 1999. Békondi C et al. [aidsmap.com]
About this Journal The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology [jiasociety.org]
Epidemiological profile of cryptococcal meningitis patients in Rio Grande do Sul, Brazil. Mycopathologia. 2008;166:71–75. 2. Pyrgos V, Seitz AE, Steiner CA, Prevots DR, Williamson PR. Epidemiology of cryptococcal meningitis in the US: 1997–2009. [dovepress.com]
Pathophysiology
2012;7:e46178, J Infect Dis 2008;197:S294 Sites Although HIV encephalitis may occur anywhere within the nervous system, there is a distinct predilection for pathologic changes to be found predominantly within subcortical white matter and basal ganglia Pathophysiology [pathologyoutlines.com]
Its pathophysiology, although not yet well characterized, is thought to be due to "indirect" effects of HIV-1 infection. HIV-1 virions are rarely detected in peripheral nerve tissue, even in patients with severe neuropathy. [hivinsite.ucsf.edu]
Except for C. gattii outbreaks in immunocompetent hosts, most patients have immune dysfunction related to the pathophysiology or treatment of an underlying autoimmune disease, malignancy, or innate immunological disorder. [dovepress.com]
Prevention
Prevention Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette. These steps can help prevent meningitis: Wash your hands. [mayoclinic.org]
It provides a comprehensive review of the epidemiology, diagnosis, and management of opportunistic infections and presents strategies for infection prevention and control. [books.google.com]
CAN MENINGITIS BE PREVENTED? Taking fluconazole when your CD4 count is below 50 can help prevent cryptococcal meningitis. But there are several reasons why most health care providers don’t use it: Most fungal infections are easy to treat. [aidsinfonet.org]
To prevent relapses, most doctors recommend that people who have had cryptococcal meningitis take fluconazole daily. Other drugs used include intravenous amphotericin B taken weekly or biweekly. [aidsinfo.nih.gov]
Can Encephalitis Be Prevented? Encephalitis can't be prevented, but you can avoid the illnesses that may lead to it. Immunizations protect kids from many common childhood illnesses. So follow the immunization schedule recommended by your doctor. [kidshealth.org]