Clinical outcome in measles patients hospitalized with complications

Measles is a highly communicable viral illness and is common cause of childhood mortality and morbidity. Keeping in view the high prevalence of measles in the developing world, we carried out this study to look into the complicated measles cases and clinical outcome in patients admitted in children ward of Ayub Teaching Hospital. Detailed history and physical examination of all the hospitalized patients with complication of measles were recorded in a proforma. Immunization and nutritional status of each admitted patient was assessed and the clinical outcome of measles was compared with demographic profile. One hundred thirty six hospitalized patients with complications of measles were studied. There was 60.3% male and 57.3% of patients were vaccinated against measles. Malnourished patients were 71.35% and had longer hospital stay [>5 days]. Pneumonia [39.7%] and diarrhoea [38.2%] were the commonest complications. Seven children died and encephalitis [57.1%] was the commonest cause of death. The most common complications of measles are pneumonia and diarrhoea with dehydration requiring admission. Malnutrition results in more complications and longer hospital stay. Mortality is significantly associated with encephalitis

Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991: a comparative retrospective analysis

We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4 percent (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm3 and blood lymphocytes lower than 350/mm3. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

Prevalencia da Encefalite por Toxoplasma em pacientes com SIDA no Hospital de Clinicas de Porto Alegre / Prevalence of toxoplasmic encephalitis in patients eith AIDS in Hospital de Clinicas de Porto Alegre

Com o objetivo de determinar a prevalencia da encefalite por toxoplasma (ET) em pacientes com SIDA, em nosso meio, bem como descrever o perfil sorologico antitoxoplasma desta populacao, revisaram-se 313 prontuarios de pacientes portadores do virus da imunodeficiencia humana (VIH) internados entre maio/85 e dezembro/89. A prevalencia presuntiva (por achados tomograficos) foi de 8,9% (28 casos). Em 192 pacientes foram dosados anticorpos antitoxoplasma (IgG) no sangue; destes 65,6% foram reagentes. Vinte e sete pacientes com ET tinham dosagem de anticorpos antitoxoplasma no sangue, sendo 26 reagentes. Quinze pacientes com ET tinham dosagem de anticorpos antitoxoplasma no sangue, sendo 26 reagentes. Quinze pacientes com ET tinham dosagem de anticorpos antitoxoplasma no liquor sendo 14 reagentes. Concluimos que a prevalencia da ET, em pacientes com SIDA, em nosso meio, e semelhante a descrita na literatura, e que maiores esforcos se devem empregar para a obtencao de material (por biopsia ou necropsia)a fim de firmar o diagnostico definitivo