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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).
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