2.Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China.
Hong-Ru LI ; Shao-Xi CAI ; Yu-Sheng CHEN ; Mei-E YU ; Neng-Luan XU ; Bao-Song XIE ; Ming LIN ; Xin-Lan HU
Chinese Medical Journal 2016;129(9):1059-1065
BACKGROUNDTalaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes.
METHODSThis was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China.
RESULTSPatients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ2 = 8.86, P= 0.010), low neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P= 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses.
CONCLUSIONSHIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective.
Adult ; Aged ; CD4 Lymphocyte Count ; Female ; HIV Infections ; complications ; Humans ; Male ; Middle Aged ; Mycoses ; diagnosis ; drug therapy ; immunology ; Retrospective Studies ; Talaromyces ; drug effects
3.Isolated and bilateral simultaneous facial palsy disclosing early human immunodeficiency virus infection.
Singapore medical journal 2015;56(6):e105-6
Bilateral lower motor neuron type facial palsy is an unusual neurological disorder. There are few reports that associate it with the human immunodeficiency virus (HIV) infection on initial presentation. A 51-year-old married woman, who was previously healthy and had no risk of HIV infection, presented solely with bilateral simultaneous facial palsy. A positive HIV serology test was confirmed by an enzyme-linked immunosorbent assay test. Following a short course of oral prednisolone, the patient recovered completely from facial palsy in three months, even though an antiretroviral treatment was suspended. Exclusion of HIV infection in patients with bilateral facial palsy is essential for early diagnosis and management of HIV.
Administration, Oral
;
Cerebrospinal Fluid Pressure
;
Enzyme-Linked Immunosorbent Assay
;
Facial Paralysis
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complications
;
drug therapy
;
Female
;
HIV Infections
;
complications
;
diagnosis
;
Humans
;
Middle Aged
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Prednisolone
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therapeutic use
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Prednisone
;
administration & dosage
4.Watch the Tongue.
Annals of the Academy of Medicine, Singapore 2015;44(12):575-576
Adult
;
Coinfection
;
HIV Infections
;
complications
;
Humans
;
Male
;
Oral Ulcer
;
complications
;
diagnosis
;
Syphilis
;
complications
;
diagnosis
;
Tongue Diseases
;
complications
;
diagnosis
5.Cognitive factors associated with the willingness for HIV testing among pregnant women in China.
Chunrong LI ; Liu YANG ; Jinwang KONG
Chinese Medical Journal 2014;127(19):3423-3427
BACKGROUNDThe spread of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in the worldwide trend is not contained effectively. The pregnant women infected HIV seriously in the high HIV epidemic areas in China. The transmission of HIV to child may be cut off if HIV positive mother was found early by HIV testing. Pregnant women mandatorily received the HIV counseling and testing services. Most of them did not know the knowledge about HIV prevention and were not willing to receive HIV testing actively. Willingness for HIV testing among pregnant women was investigated, which can help to promote them to take up HIV testing actively. This study assessed the prevalence of the willingness for HIV testing and cognitive factors associated with it.
METHODSA cross-sectional survey was conducted to 500 pregnant women via face-to-face interviews with anonymous structured questionnaire guided by the Health Belief Model (HBM).
RESULTSThe prevalence of the willingness for HIV testing was 58.60%. Perceived higher susceptibility to HIV (multivariate-adjusted odds ratio (ORm) = 2.02, 95% confidence interval (CI): 1.40-5.06), more knowledge for HIV (ORm = 1.92, 95% CI: 1.11-3.87) and perceived less social stigma (ORm = 0.80, 95% CI: 0.34-0.91) were associated with higher willingness for HIV testing among pregnant women.
CONCLUSIONTo prevent HIV mother to children transmission, it is necessary to enhance knowledge for HIV, change cognitive factors and increase willingness for HIV testing among pregnant women.
Adult ; China ; Cross-Sectional Studies ; Female ; HIV ; pathogenicity ; HIV Infections ; diagnosis ; Humans ; Infectious Disease Transmission, Vertical ; Middle Aged ; Multivariate Analysis ; Patient Acceptance of Health Care ; psychology ; Pregnancy ; Pregnancy Complications, Infectious ; diagnosis ; Surveys and Questionnaires ; Young Adult
7.Analysis of tongue figure features in 990 cases of sexually transmitted and intravenous drug use spread HIV infected population in Xinjiang.
Ying ZHANG ; Jian-Ping MA ; Xiu-Lan MA ; Lin ZENG ; Aihemaiti ABUDUREYIMU ; Jing-Ru LI
Chinese Journal of Integrated Traditional and Western Medicine 2014;34(7):816-818
OBJECTIVETo investigate the tongue manifestation features of sexually transmitted and intravenous drug use spread HIV infected population in Xinjiang.
METHODSRecruited were 990 HIV infected subjects in Xinjiang from May 2011 to March 2012, who were assigned to the intravenous drug use spread HIV infected (498 cases) and the sexually transmitted (492 cases). By using tongue figure shoot combined with analyses of experts, tongue manifestations were analyzed and compared between the sexually transmitted and the intravenous drug use spread from four aspects, i.e., the tongue color, the tongue shape, the fur color, and the fur property.
RESULTSCompared with the sexually transmitted population, red tongue, fissured tongue, yellow fur, thick fur, eroded fur, deficiency of fur fluid were more often seen, showing statistical difference (P < 0.05). Compared with the intravenous drug use spread population, pale tongue, white fur, and thin fur were more often seen, showing statistical difference (P < 0.05).
CONCLUSIONSThe tongue manifestations of the intravenous drug use spread HIV population reflected inner exuberance of evil toxin and heat impairing qi and yin. Compared with the intravenous drug use spread population, the attack of HIV infection was more hiding in the sexually transmitted population, with milder internal injury. Their Wei-qi was not damaged and no obvious change occurred in the tongue figure.
Adolescent ; Adult ; Aged ; Female ; HIV Infections ; diagnosis ; etiology ; pathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Sexually Transmitted Diseases, Viral ; diagnosis ; pathology ; Substance-Related Disorders ; complications ; diagnosis ; Tongue ; pathology ; Young Adult
8.Ostraceous and inverse psoriasis with psoriatic arthritis as the presenting features of advanced HIV infection.
Rochelle Lorenzo CASTILLO ; Geraldine Zamora RACAZA ; Francisca Dela Cruz ROA
Singapore medical journal 2014;55(4):e60-3
Knowledge of both the common and atypical presentations of human immunodeficiency virus (HIV)-associated dermatoses may be helpful in arousing suspicion of HIV, especially in patients with no reported risk factors. Herein, we report the case of an otherwise healthy, nonpromiscuous 29-year-old man who presented to our institution with an eight-week history of plaques with oyster shell-like scales on the trunk, extremities and genital area. The plaques were associated with fever, and intermittent knee pain and swelling. Initial diagnostic tests were suggestive of drug hypersensitivity syndrome, and the patient's condition improved with treatment using oral prednisone. However, the lesions recurred when the dose of prednisone was tapered, even after the culprit drug had long been discontinued. Repeat skin punch biopsy and arthrocentesis revealed a diagnosis of psoriasis vulgaris with psoriatic arthritis. Due to the atypical presentation of psoriasis, the patient was counselled to undergo HIV testing, which came back positive. Clinicians should be attuned to the skin signs heralding HIV/acquired immunodeficiency syndrome, in order to facilitate early diagnosis and treatment.
Administration, Oral
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Adult
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Arthritis, Psoriatic
;
complications
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Biopsy
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Diagnosis, Differential
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HIV Infections
;
complications
;
diagnosis
;
Humans
;
Male
;
Prednisone
;
administration & dosage
;
Psoriasis
;
complications
;
Risk Factors
;
Treatment Outcome
10.Henoch-Schönlein purpura associated with adult human immunodeficiency virus infection: case report and review of the literature.
Masliza ZAID ; Keefe TAN ; Nares SMITASIN ; Paul Ananth TAMBYAH ; Sophia ARCHULETA
Annals of the Academy of Medicine, Singapore 2013;42(7):358-360
Acute Kidney Injury
;
blood
;
etiology
;
therapy
;
Anti-Retroviral Agents
;
administration & dosage
;
CD4 Lymphocyte Count
;
Disease Progression
;
Embolization, Therapeutic
;
methods
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Fatal Outcome
;
Gastrointestinal Hemorrhage
;
diagnostic imaging
;
etiology
;
physiopathology
;
therapy
;
Glucocorticoids
;
administration & dosage
;
HIV Infections
;
complications
;
diagnosis
;
immunology
;
HIV-1
;
drug effects
;
isolation & purification
;
Humans
;
Male
;
Middle Aged
;
Purpura, Schoenlein-Henoch
;
complications
;
diagnosis
;
physiopathology
;
Radiography
;
Renal Dialysis
;
methods

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