ABSTRACT
Hydrocephalus is a serious complication of tuberculous meningoencephalitis in HIV patients. The disease can affect vital and functional prognosis of patients. A 20 years-old woman was admitted for deterioration of her consciousness. She has a history of HIV infection since 3 months. Cerebral imagery showed signs of tuberculous meningoencephalitis. The paient was treated by antituberculous therapy with a good evolution. At the third months of treatment the patient presented roughly alteration of her consciousness and intracranial hypertension. Cerebral scan showed active ventricle hydrocephalous. The patient had ventricle extern derivation and then ventricle peritoneal derivation. Antituberculous and antiretroviral therapies were maintained. The outcome was favourable [follow up of one year]. central nervous system involvement in HIV patient can be observed at any stage of the disease with a consequent mortality and morbidity. central nervous system tuberculosis is observed in 10% of patients who presented an association of HIV-tuberculosis and only in 2% to 5% of tuberculous immunocompetent patients. Hydrocephalous is observed in 32% to 51% of HIV patients associated with tuberculosis meningoencephalitis. Hydrocephalous is a common complication of tuberculous meningoencephalitis witch can worsened the neurological statue of HIV infected patient. An early surgical and medical management was associated with a good prognosis
ABSTRACT
The purpose of this study was to evaluate the levels of zinc [Zn], copper [Cu], iron [Fe] and zinc/ copper ratio in the serum of patients with cutaneous leishmaniasis in Qom Provinces, center of Iran. Serum levels of zinc and copper were determined by flame atomic absorption spectrophotometer and serum iron concentration was measured by using an auto analyzer. The study group consisted of 60 patients with cutaneous leishmaniasis and the control group of 100 healthy volunteers from the same area who were not exposed to cutaneous leishmaniasis. There were no statistically significant differences in age and body mass index between the two groups. Serum Zn [P<0.001] and Fe [P<0.05] levels were lower in patients with cutaneous leishmaniasis than the control group. We also found serum Cu concentration [P<0.05] in the patient group was significantly higher than that of the control group. However, zinc/copper ratio [P<0.001] was lower in patients with cutaneous leishmaniasis than in the control group. Our data indicated that Zn/Cu ratio was significantly lower in patients with CL as compared to the controls. Earlier reports suggest that, this ratio imbalance could be a useful marker for immune dysfunction in leishmaniasis. There was also strong association of Zn, Cu and Fe with CL. It suggests the use of blood zinc, copper, iron concentration and the copper/zinc ratio [Zn/Cu], as a means for estimating the prognosis of CL