OROPHARYNGEAL MANIFESTATIONS IN HIV INFECTED PATIENTS

Objectives: We aimed to determine the prevalence of oropharyngeal manifestations in HIV infected patients. Materials and methods: A retrospective study on 824 patients found in the evidences of the Infectious Diseases Clinic in Iasi, diagnosed in different stages of HIV infection and admitted to hospital between January the 1 st and December the 31st of 2010. Results: Oropharyngeal manifestations appeared in less than half of all patients (43.4%), the majority of which were between 15 and 24 years old (66.3%). The most frequent lesion was oral candidiasis 72.19%, followed by gingivostomatitis 72 cases (20.24%), infections with herpes virus 13 cases (3.65%), aphthous stomatitis 11 cases (3,08%), Kaposi’s sarcoma 2 cases and hairy leukoplakia 1 case. Oral lesions were associated mostly with the degree of imunosupresion and the level of CD4 cells. Conclusions: The degree of imunosupresion correlates significantly with the manifestations of oral infections, especially in patients suffering from candidiasis and with Kaposi’s sarcoma. The oral lesions with the highest frequency spotted by our study were oral erythematous candidiasis and gingivostomatitis

Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis.

Tuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae.Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing countries.We performed a retrospective analysis of the 127 adult and 77 pediatric cases diagnosed with TBM in the Infectious Disease Hospital of the School of Medicine of Iasi, Romania between 2004-2013.Definite diagnosis of TBM was established in 31% of children but in only 20% of adults (p = 0.043). A contact with an individual with pulmonary tuberculosis was documented in 30% of children vs. 13% of adults (p = 0.0007). Coma occurred in 19% of patients (similar in children and adults); other consciousness abnormalities were seen in 27% of children and in 72% of adults (p = 0.000001). Cranial nerve palsies occurred prior to therapy in 9% of cases (12% vs 7% of children and adults, respectively, p>0.05), and developed 2-7 days after treatment initiation in 10% (12 vs 9%). CSF cultures were positive for M. tuberculosis in 24% of patients (31% vs. 20%, p>0.05). Overall mortality was 7.35%, similar for children and adults. Yet, permanent neurological sequelae, which were seen in 23% of patients occurred significantly more frequent in children vs. adults (36% vs. 14%, respectively, p = 0.0121). In conclusion, our retrospective analysis on a significant number of cases of TBM identified striking differences between children and adults: while children were in an earlier stage at the admission, they associated a higher frequency of neurological sequelae and miliary pattern, and they were more likely to have normal CSF protein levels and positive cultures of CSF

Clinical features and infection outcome in patients with TBM.

<p>Data are presented as n (%)</p><p>Clinical features and infection outcome in patients with TBM.</p

Epidemiological aspects, case definition and stage of TBM on admission.

<p>Data are presented as n (%)</p><p>Epidemiological aspects, case definition and stage of TBM on admission.</p