Meningitis in HIV patients in Tirgu-Mures

Scientific coordinator: Dr. Garbovan Cristina Author : Petroi Raluca

Coauthor: Pocol Oana

IntroductionThe clinical conseqence of progressive

infection with HIV is the development of opportunistic infection as a rsult of progressive loss of immune function.

Although there are many potential pathogens can complicate AISD , only a very limited number can cause meningitis.

Material and methodWe have made a retrospective study on

14 patients who were admitted in Disseas Clinic I from Tirgu Mures between 01.01.2012-31.12.2013.

the studied criteria were etiology , clinical parameters like LCR , ionogram, hemoleucogram and treatment of meningitis.

Etiology

Different forms of meningitis are associated with HIV infection. They may be classified as follows, according to the etiologic agent:

-cryptococcal-tuberculous-listeria species -toxoplasmosis

In Tirgu Mures the etiology of this

patients is:

57%14%

7%

21%MENINGITE CU B.K.MENINGITE DE ETIOLOGIE NEPRECIZATAMENINGITE CU TOXOPLASMOZAMENINGITE CU CRYPTOCOCCUS

Clinical presentation

In general, symptoms and signs typically associated with meningitis are less likely to occur in HIV-seropositive individuals than in the general population. This probably reflects the different organisms involved and the differences in immune responses.

Less frequent findings are confusion ,somnolence and personality changes.

15%

21%

21%8%

25%

10%TUBERCULOSISHEPATIC CRONIC DISSEASORAL CANDIDIASISPNEUMONIAWASTING SINDROMSENSITIVE NEUROPATIE

Distribution of patients by associated pathology

Distribution of patients by the changes of leukocytes

14%

36%

50%<10002000-4000>4000

Distribution of patients by the changes of hemoglobin

14%

43%

29%

14%

6-8 Hb 8-11 Hb11-13 Hb>13 Hb

Distribution of patients by the changes of potasium

7%

86%

7%

<3.3 mmol/l3.3-5.1mmol/l>5.1mmol/l

Distribution of patients by the changes of sodium

43%

50%

7%

<135mmol/l135-145 mmol/l>145 mmol/l

Distribution of patients by the aspect of the LCR

79%

21%

clearopalescent

Distribution of patients by Pandy reaction

43%

14%

21%

7%

7%

7%

-+/-++++++++++

Distribution of patients by the changes of glucoses in LCR

29%

43%

21%

7%

not done<50mg/dl50-70mg/dl>70mg/dl

Distribution of patients by the changes of proteine in LCR

36%

21%

43%not done<15mg/dl15-45mg/dl>45mg/dl

Meningitis in patients with HIV disease is most frequently due to opportunistic infections. Thus, predictions center on the likelihood of controlling opportunistic infection.

The best way to prevent opportunistic infections is to give effective antiretroviral therapy - the future epidemiology of opportunistic infections is inextricably linked with the effectiveness of future antiretroviral treatment

Coclusions