Differential diagnosis of lung`s lesions in HIV-infected patients

Introduction. Occurring of intercurrent diseases in HIV-infected and AIDS patients depends on the state of cellular and humoral immunity, on the level of CD4 + cells, which is reduced to 300 cells/ml and it is determining factor for the occurrence of a secondary pathology. In Ukraine a co-infection:...

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Main Authors: N. O. Skorohodova, E. N. Raznatovskaya, R. N. Yasinskiy
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2013-08-01
Series:Zaporožskij Medicinskij Žurnal
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Online Access:http://zmj.zsmu.edu.ua/article/view/16834/14520
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author N. O. Skorohodova
E. N. Raznatovskaya
R. N. Yasinskiy
author_facet N. O. Skorohodova
E. N. Raznatovskaya
R. N. Yasinskiy
author_sort N. O. Skorohodova
collection DOAJ
description Introduction. Occurring of intercurrent diseases in HIV-infected and AIDS patients depends on the state of cellular and humoral immunity, on the level of CD4 + cells, which is reduced to 300 cells/ml and it is determining factor for the occurrence of a secondary pathology. In Ukraine a co-infection: tuberculosis and HIV/AIDS – has a malignant character, it has an extremely unfavorable course and high numbers of deaths from primarily diagnosed tuberculosis. The aim of the study. On example of clinical cases to show the difficulties in the differential diagnosis of pulmonary lesions in HIV-infected patients. Materials and methods. The clinical examples of patients with lungs diseases, associated with HIV infection, who were in the department of pulmonary tuberculosis № 1 Zaporizhzhya antituberculosis clinical dispensary were analyzed in this article. The results of research. The clinical examples. Patient C had clinical manifestations of respiratory system lesions, according to the X-ray: with bilateral lung cavities in them. Mycobacteria, Cryptococcus and Pneumocystis were not detected in the sputum. In blood cultures St. aureus was received. Patient U being in poor state with severe intoxication was treated in the intensive care unit. According to autopsy Pneumocystis pneumonia with endogenous intoxication and cerebral edema were revealed. HAART and prevention by Biseptol significantly reduced the incidence of Pneumocystis pneumonia. However, some patients in Ukraine absolutely refuse from both examination and treatment in centers of immune correction and therefore they are admitted to hospital in a critical state. Patient K had both symptoms of intoxication syndrome and symptoms of the respiratory system lesions. After a course of antibiotic treatment his state did not improve, neurological symptoms appeared. Cryptococcus were found in the cerebrospinal fluid. Patient A was admitted to the department with manifestations of intoxication syndrome and symptoms of lesions of the respiratory system. The microfocal dissemination was found in his lungs. HIV was primarily identified. She was treated irregularly, she took injected drugs. An acute intoxication after using unidentified narcotic substance was detected at autopsy. Conclusion. HIV-infected people in most cases are often drug users, that results in lesions of various organs and systems, that’s why it causes some difficulties in differential diagnosis. To reduce mortality from opportunistic infections and drug abuse it`s necessary to conduct measures to form commitment to highly active antiretroviral therapy (HAART) and to treat drug dependence.
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spelling doaj-art-dcb4f617f4fd4f778d6c5e6e82c1db092025-08-20T03:23:56ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102013-08-0143538http://dx.doi.org/10.14739/2310-1210.2013.4.16834Differential diagnosis of lung`s lesions in HIV-infected patientsN. O. SkorohodovaE. N. Raznatovskaya R. N. YasinskiyIntroduction. Occurring of intercurrent diseases in HIV-infected and AIDS patients depends on the state of cellular and humoral immunity, on the level of CD4 + cells, which is reduced to 300 cells/ml and it is determining factor for the occurrence of a secondary pathology. In Ukraine a co-infection: tuberculosis and HIV/AIDS – has a malignant character, it has an extremely unfavorable course and high numbers of deaths from primarily diagnosed tuberculosis. The aim of the study. On example of clinical cases to show the difficulties in the differential diagnosis of pulmonary lesions in HIV-infected patients. Materials and methods. The clinical examples of patients with lungs diseases, associated with HIV infection, who were in the department of pulmonary tuberculosis № 1 Zaporizhzhya antituberculosis clinical dispensary were analyzed in this article. The results of research. The clinical examples. Patient C had clinical manifestations of respiratory system lesions, according to the X-ray: with bilateral lung cavities in them. Mycobacteria, Cryptococcus and Pneumocystis were not detected in the sputum. In blood cultures St. aureus was received. Patient U being in poor state with severe intoxication was treated in the intensive care unit. According to autopsy Pneumocystis pneumonia with endogenous intoxication and cerebral edema were revealed. HAART and prevention by Biseptol significantly reduced the incidence of Pneumocystis pneumonia. However, some patients in Ukraine absolutely refuse from both examination and treatment in centers of immune correction and therefore they are admitted to hospital in a critical state. Patient K had both symptoms of intoxication syndrome and symptoms of the respiratory system lesions. After a course of antibiotic treatment his state did not improve, neurological symptoms appeared. Cryptococcus were found in the cerebrospinal fluid. Patient A was admitted to the department with manifestations of intoxication syndrome and symptoms of lesions of the respiratory system. The microfocal dissemination was found in his lungs. HIV was primarily identified. She was treated irregularly, she took injected drugs. An acute intoxication after using unidentified narcotic substance was detected at autopsy. Conclusion. HIV-infected people in most cases are often drug users, that results in lesions of various organs and systems, that’s why it causes some difficulties in differential diagnosis. To reduce mortality from opportunistic infections and drug abuse it`s necessary to conduct measures to form commitment to highly active antiretroviral therapy (HAART) and to treat drug dependence.http://zmj.zsmu.edu.ua/article/view/16834/14520HIV-infectionpneumocystis pneumoniacryptococcosisstaphylococcal pneumonia
spellingShingle N. O. Skorohodova
E. N. Raznatovskaya
R. N. Yasinskiy
Differential diagnosis of lung`s lesions in HIV-infected patients
Zaporožskij Medicinskij Žurnal
HIV-infection
pneumocystis pneumonia
cryptococcosis
staphylococcal pneumonia
title Differential diagnosis of lung`s lesions in HIV-infected patients
title_full Differential diagnosis of lung`s lesions in HIV-infected patients
title_fullStr Differential diagnosis of lung`s lesions in HIV-infected patients
title_full_unstemmed Differential diagnosis of lung`s lesions in HIV-infected patients
title_short Differential diagnosis of lung`s lesions in HIV-infected patients
title_sort differential diagnosis of lung s lesions in hiv infected patients
topic HIV-infection
pneumocystis pneumonia
cryptococcosis
staphylococcal pneumonia
url http://zmj.zsmu.edu.ua/article/view/16834/14520
work_keys_str_mv AT noskorohodova differentialdiagnosisoflungslesionsinhivinfectedpatients
AT enraznatovskaya differentialdiagnosisoflungslesionsinhivinfectedpatients
AT rnyasinskiy differentialdiagnosisoflungslesionsinhivinfectedpatients