A patient with AIDS developed the Capgras' syndrome as part of an acute confusional state resulting from an opportunistic infection. Neuropsychological testing suggested non-dominant hemisphere dysfunction with impaired facial recognition. Serial CT scanning showed a right parietal lesion which resolved after the psychosis improved. These findings provide further evidence for ...

A simple non-bronchoscopic bronchoalveolar lavage method was used in 30 patients with the acquired immunodeficiency syndrome undergoing assisted ventilation for respiratory failure. A modified Argyle Levin stomach tube was passed via the endotracheal tube and lavage performed. The lavage was well tolerated and performed quickly and easily, required little training, ...

The first twenty-one cases of Paediatric Acquired Immunodeficiency Syndrome (PAIDS) in Trinidad and Tobago were studied. An overwhelming majority of patients were of African descent. Most of the children presented within the first year of life, the average time between presentation and death was 4 1/2 months, and the majority ...

Infection with Mycobacterium tuberculosis is frequently found in patients with acquired immunodeficiency syndrome and can result in diffuse lymphadenopathy from disseminated disease. A case is presented of esophageal erosion and perforation secondary to mediastinal lymph node enlargement from Mycobacterium tuberculosis in a patient positive for human immunodeficiency virus. Emergent surgical ...

Disseminated histoplasmosis is an increasingly important opportunistic infection in patients with the acquired immunodeficiency syndrome (AIDS). We report the first case of histoplasmosis as a cause of pleural effusion in a patient with AIDS. Recognition of the typical intracellular yeast on a Wright-Giemsa stained smear of the pleural fluid cells ...

We report a case of acquired von Willebrand's syndrome with severe gastrointestinal bleeding and associated free monoclonal lambda light chains. The patient had a rapid sustained clinical and laboratory response to the administration of prednisone. Of note in this patient was the occurrence of angiodysplasia which has previously been reported ...

This review attempts to assess critically the literature on the neuropathology of acquired immunodeficiency syndrome in light of our experience with 172 patients with acquired immunodeficiency syndrome who underwent extensive postmortem examinations of the central and peripheral nervous systems. The neuropathologic manifestations of the disease can be divided into three ...

Common variable immunodeficiency is a heterogeneous syndrome which may occur at any age and may be associated with recurrent sinopulmonary and gastro-intestinal infections, atopic illness, autoimmune disorders and varying degrees of hypogammaglobulinaemia (1). The clinical syndrome is very similar to that described in X-linked agamma-globulinaemia but the mode of inheritance ...

Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium ...

A patient with confirmed acquired immune deficiency syndrome (AIDS) and disseminated Kaposi's sarcoma was seen in the Eye Clinic, Kenyatta National Hospital, and was found to have involvement of the conjunctiva and lids, confirmed by biopsy. He also had retinal haemorrhages and cotton-wool spots. Kaposi's sarcoma of the conjunctiva may ...

Kaposi's sarcoma has only rarely been reported in children with acquired immunodeficiency syndrome. In contrast to adult patients, in whom the disease is predominantly cutaneous, among pediatric patients with acquired immunodeficiency syndrome, Kaposi's sarcoma is primarily limited to the lymphadenopathic form. We describe two children with the acquired immunodeficiency syndrome ...

The ability to recognize disease related to the human immunodeficiency virus (HIV) and subsequent acquired immunodeficiency syndrome (AIDS) has improved in recent years with refinement of laboratory techniques. Because of this progress, several clinical conditions can now be identified as "pre-AIDS" syndromes. These include the persistent generalized lymphadenopathy syndrome, immune ...

A patient with acquired immunodeficiency syndrome-related complex was examined for fever and hepatosplenomegaly. During his hospitalization, liver failure developed in the patient, and he became infected with Pseudomonas and Staphylococcus. At autopsy, in addition to signs of bacterial infection, malignant histiocytic infiltrates were found that involved his liver, spleen, lymph ...

The authors present a rare case of bilateral aberrant oculomotor regeneration following severe head trauma with the unusual finding of unilateral palpebral fissure widening on abduction with normal lateral rectus function (oculomotor-abducens synkinesis). The findings do not match the usual syndromes of either acquired oculomotor synkinesis or acquired Duane's retraction ...

A hemophiliac with acquired immunodeficiency syndrome-related complex was seen with sepsis related to a ventricular septal abscess. The abscess was debrided and the septum was patched with a single layer of autologous pericardium. The patient recovered and survived 6 months before dying of acquired immunodeficiency syndrome. At autopsy, the septal ...

The acquired immunodeficiency syndrome epidemic has led to significant medicolegal concerns in the areas of informed consent and confidentiality. These legal concepts are directed at preserving respect for individual autonomy and privacy in the face of the epidemic. Emerging legal doctrines and issues related to consent and confidentiality are outlined, ...

A 66 year old female with a long history of recurrent pulmonary infection presented with a full-blown malabsorption syndrome. She was found to be suffering from acquired immunodeficiency. She later developed non-Hodgkin's lymphoma of the cervical lymph nodes. The possible relationships between immunodeficiency, malabsorption and lymphoma are discussed.

I analyzed trends in the survival of 36,847 adults who were diagnosed with acquired immunodeficiency syndrome between January 1984 and September 1987 under the pre-1987 surveillance definition of acquired immunodeficiency syndrome. For patients in whom Pneumocystis carinii pneumonia was among the first manifestations of acquired immunodeficiency syndrome, the estimated 1-year ...

The concept of inappropriate macrophage activation (IMA) embraces the clinicopathologic conditions associated with non-malignant lymphohistiocytic proliferation: familial lymphohistiocytosis (FLH) and hemophagocytic syndromes associated with viral, bacterial, fungal or parasitic infections in both immunodeficient and immunocompetent patients. IMA is also observed during the clinical course of primary immunodeficiencies (Chediak Higashi). The ...

We treated a 5-year-old girl and a 6-year-old boy with acquired Brown's syndrome associated with pansinusitis. In both patients, the diagnosis was established roentgenographically, and the patients were treated with oral antibiotics. Systemic corticosteroids were used in one case, although their clinical value was uncertain. Patients presenting with acute-onset Brown's ...

A case of crusted (Norwegian) scabies in a patient with the acquired immunodeficiency syndrome (AIDS) is described and seven previous reports of this association are reviewed. Injury to epidermal Langerhans' cells by the human immunodeficiency virus or cytotoxic cells may explain the appearance of this unusual form of scabies in ...

Six men with acquired immunodeficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis, treated with combined ganciclovir induction therapy and hyperimmune globulin (CMV-IGIV) for 10 days followed by CMV-IGIV alone, had a median time to retinitis progression shorter (7 days) than had eight historical controls given ganciclovir maintenance therapy (54 days; P ...

An 8-year-old male underwent excision of an encapsulated thymoma. Four months later he presented with disseminated, fatal varicella. Evaluation of his immune status during the terminal illness revealed hypogammaglobulinemia and lymphopenia consistent with a diagnosis of Good's syndrome (immunodeficiency with thymoma). This is the first case of Good's syndrome reported ...

Fibrosis of the corpus spongiosum, caused by urethral manipulation, and the resulting ventral penile curvatures are known as the urethral manipulation syndrome. This acquired, largely iatrogenic deformity is noticed only be sexually active patients. Partial, gradual disappearance of glans engorgement and irregularities palpable along the penile urethra associated with ventral ...

The recovery rates of cytomegalovirus from mucolysed induced sputum samples and bronchoalveolar lavage fluid obtained from individuals at risk for or with acquired immunodeficiency syndrome were compared. It was demonstrated that cytomegalovirus could be reliably recovered from mucolysed induced sputum, and such recovery was highly predictive of recovery from bronchoalveolar ...

A 42-year-old man presented with herpes zoster ophthalmicus on the right side. He was found to have acquired immune deficiency syndrome-related complex. Two weeks later he developed toxoplasmic retinochoroiditis in the left eye. He also presented later with left hemiplegia, which was probably caused by herpes zoster arteritis. Nine months ...

With the growing number of patients with the acquired immunodeficiency syndrome there has been a marked increase in the incidence of Kaposi's sarcoma. Kaposi's sarcoma of the penis was the initial presenting manifestation of acquired immunodeficiency syndrome in 4 patients. Overall, less than 3% of all acquired immunodeficiency syndrome patients ...

Free plasma tryptophan levels in patients with fibrositis syndrome were measured by Moldofsky and Warsh with the view that the pathogenesis of fibrositis syndrome might involve a functional deficiency of serotonin. The hypothesis was supported by the finding of an inverse relationship between tryptophan concentration and the severity of musculoskeletal ...

Kaposi's sarcoma and disseminated sporotrichosis of the skin and joints developed simultaneously in a homosexual man with antibodies to human immunodeficiency virus. There was no identified source of exposure to Sporothrix organisms. Sporotrichosis may be a presenting opportunistic infection associated with acquired immunodeficiency syndrome and tends to be disseminated at ...

In patients with the acquired immunodeficiency syndrome, mycobacterial lymphadenitis is characterized by the presence of numerous acid-fast bacilli within histiocytes. In Diff-Quik-stained cytologic preparations of such lymph nodes, performed during intraoperative consultations, the presence of mycobacteria is manifested by numerous negatively staining rod-shaped spaces intracellularly within histiocytes, as well as ...

The etiology of keratoconus is still unclear. This study presents a new clinical sign, Thalasselis' syndrome, defined as: an association between keratoconus, magnesium deficiency, type-A behavior and allergy. Also, it introduces the hypothesis that magnesium deficiency could affect pathologically the osmotic mechanism of the cornea, specifically the Na-K and/or Ca-ATPase ...

Two patients with acquired immunodeficiency syndrome presented unusual keratotic cutaneous lesions with a protracted course. Pathologic examination in both patients, cultures, and DNA hybridization techniques of skin biopsy specimens in the second patient were characteristic of cytomegalovirus cutaneous infection. Cytomegalovirus skin lesions are rarely described in acquired immunodeficiency syndrome in ...

Pleural effusion is an unusual presentation of cryptococcal infection in the acquired immune deficiency syndrome. Previous investigators have established the diagnosis of cryptococcal pleural disease by culturing pleural fluid, bronchial washings, and extrapulmonary sources. We report the first case of cryptococcal pleural effusion proved by closed pleural biopsy. Pleural biopsy ...

Rahnella aquatilis, a rare enteric gram-negative rod which is usually found in fresh water, was isolated from the bronchial washing of a patient with acquired immunodeficiency syndrome. Although few clinical isolates have been reported, this is the second isolation of R. aquatilis from a human in North Carolina. A case ...

Two homosexual men positive for human immunodeficiency virus with evidence of acquired cellular immunodeficiency were diagnosed recently to have seminoma of the testis. One man has the acquired immunodeficiency syndrome with lymphopenia, a low CD4:CD8 ratio, condylomata accuminata, pneumocystis carinii and cerebral toxoplasmosis, and 1 has an acquired immunodeficiency syndrome ...

Forty pediatric patients seropositive for human immunodeficiency virus antibody and conforming to Centers for Disease Control, Atlanta, Ga, case definition of acquired immunodeficiency syndrome underwent ophthalmic examinations to evaluate prospectively the incidence, type, and natural history of ocular involvement in pediatric acquired immunodeficiency syndrome. A total of 87 examinations were ...

Pneumocystis carinii pneumonia was diagnosed by bronchoalveolar lavage of the upper lobes in a patient with the acquired immunodeficiency syndrome (AIDS) receiving aerosol pentamidine prophylaxis. Serendipitous availability of a normal premorbid lung gallium scan indicated that pneumocystosis had developed during aerosol pentamidine prophylaxis; at the time of presentation a repeat ...

Sclerosing cholangitis, an inflammatory disease of the biliary tree that occurs infrequently in childhood, has been recognized in combination with papillary stenosis in adults with the acquired immunodeficiency syndrome. A 10-yr-old child with a familial immunodeficiency syndrome characterized by defective T-cell function and deficiencies of immunoglobulins A and G developed ...

The hyperviscosity syndrome is most commonly seen in association with monoclonal gammopathies and has only rarely been described in association with polyclonal hypergammaglobulinemia. We have recently seen a patient with known acquired immunodeficiency syndrome who presented with the hyperviscosity syndrome in the setting of polyclonal hypergammaglobulinemia. To our knowledge, this ...

We describe a patient with acquired immune deficiency syndrome (AIDS) and disseminated histoplasmosis. He presented with a mild inflammatory dermatitis that improved with topical steroid treatment but was proven to be cutaneous histoplasmosis. The clinical presentations, diagnosis, histopathologic basis, and treatment of disseminated Histoplasma capsulatum in patients with AIDS are ...

We describe a 29-year-old homosexual man with acquired immunodeficiency syndrome who developed pericardial effusion and tamponade. Pericardiocentesis resulted in clinical improvement. All diagnostic tests on pericardial fluid were negative. At autopsy, extensive plaques and nodules of Kaposi's sarcoma were found studding the epicardium, and no other cause of effusion was ...

Bilateral enlargement of the parotid glands has been noted in five patients who are seropositive for antibody to the human immunodeficiency virus. A characteristic cystic appearance has been noted in these lesions on clinical and radiographic examination. A benign lymphoepithelial infiltrate with cystic degeneration is found in parotid specimens from ...

Pulmonary cavitation is an infrequent manifestation of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. The pathogenesis of lung cavities associated with P carinii pneumonia has not been fully elucidated by detailed morphologic studies. This article describes a patient with the acquired immunodeficiency syndrome and P carinii pneumonia ...

We report a case of perianal non-Hodgkin's lymphoma that presented as a perianal abscess in an otherwise asymptomatic intravenous drug abuser who tested positively for human immunodeficiency virus infection. Extranodal lymphoma of the anal canal is a very rare event, which has recently been described in homosexual men with the ...

In a 30-year-old homosexual man with a 3-year history of localized psoriasis, an oligoarthropathy and severe cutaneous lesions of Reiter's syndrome developed 6 months after acquired immunodeficiency syndrome (AIDS) was diagnosed. Reiter's syndrome and psoriasis may be a continuum of similarly expressed cutaneous diseases that develop in genetically predisposed individuals. ...

A 30-year-old homosexual man with the acquired immune deficiency syndrome and a recent history of zoster involving the mandibular division of the right trigeminal nerve was found at autopsy to have a predominantly demyelinating lesion restricted to the ipsilateral spinal trigeminal tract and nucleus. Cowdry A inclusions were readily apparent ...

Head and neck manifestations are particularly frequent in the acquired immune deficiency syndrome. An unusual case of acquired immune deficiency syndrome in a female prostitute whose initial presentation included a palatal perforation is reported. This case is also noteworthy because the patient died of disseminated miliary tuberculosis, a disease only ...

In three of eight patients with the acquired immune deficiency syndrome the Pneumocystis carinii pneumonia treated with intravenous trimethoprim sulfamethoxazole, drug-related reactions occurred 9, 10, and 13 days after therapy. The symptom complex consisted of a maculopapular eruption, fever, eosinophilia, and leukopenia. Oral desensitization with graded doses of trimethoprim sulfamethoxazole ...

We isolated Bordetella pertussis from three patients with acquired immunodeficiency syndrome who underwent diagnostic bronchoscopy for evaluation of respiratory symptoms. The B. pertussis isolates were recovered from medium (charcoal-yeast extract agar) formulated to enhance recovery of Legionella spp., and one of the isolates stained positively with antisera directed against Legionella ...

Cytomegalovirus (CMV) is an important cause of acalculous gangrenous cholecystitis in immunocompromised persons. We report a case of acalculous acute cholecystitis and active colitis associated with CMV in a patient suffering from the acquired immune deficiency syndrome. The condition was treated successfully with surgery and 9-(1,3,-dihydroxy-2-propoxymethyl)guanine intravenously.