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1996-02-26
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Document 0019
DOCN M9620019
TI Clinical correlates of secondary meningitis in HIV-infected adults.
DT 9602
AU Friedmann PD; Samore MH; Kraemer KL; Calkins DR; Division of General
Internal Medicine, Deaconess Hospital,; Boston, Mass., USA.
SO Arch Intern Med. 1995 Nov 13;155(20):2231-7. Unique Identifier :
AIDSLINE MED/96048974
AB BACKGROUND: Neurologic complaints are common in adults infected with the
human immunodeficiency virus, but little is known about which clinical
features are associated with secondary causes of meningitis. METHODS: A
retrospective cross-sectional study of adults infected with the human
immunodeficiency virus who received a diagnostic lumbar puncture (LP) in
the infectious disease clinic, emergency department, and inpatient wards
of the Deaconess Hospital, Boston, Mass, from 1989 through 1992 to
determine which clinical features available at the time of LP are
correlated with definite or probable secondary meningitis. RESULTS: Of
the 491 LPs, 90% were performed in whites, 93% in men, and 11% in
injection drug users. Cerebrospinal fluid test results revealed
secondary meningitis in 39 (7.9%) of 491 LPs performed on 322
individuals. Cryptococcal meningitis was the predominant type (27
cases); no bacterial or tuberculous meningitis was found. In
multivariate analyses, a history of non-Hodgkin's lymphoma (adjusted
odds ratio [OR], 4.3; 95% confidence interval [CI], 1.5 to 12.5), a
history of herpes simplex virus infection (OR, 2.5; 95% CI, 1.2 to 5.0),
nausea and/or vomiting (OR, 2.0; 95% CI, 1.03 to 4.0), headache in a
person with the acquired immunodeficiency syndrome (OR, 2.1; 95% CI,
1.03 to 4.4), and cranial nerve abnormalities (OR, 5.1; 95% CI, 1.8 to
14.1) were positive correlates of opportunistic meningitis; current
fluconazole use (OR, 0.3; 95% CI, 0.1 to 0.8) conferred a lower risk.
CONCLUSION: In similar clinical settings, physicians and their human
immunodeficiency virus-infected patients should consider these features
when assessing the risk of secondary meningitis and the necessity for
immediate LP.
DE Adult *AIDS-Related Opportunistic Infections Cross-Sectional Studies
Female Human HIV Infections/COMPLICATIONS Male Meningitis/*VIROLOGY
Prevalence Retrospective Studies Sensitivity and Specificity Spinal
Puncture Support, Non-U.S. Gov't JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).