Cerebrospinal fluid syndromes in HIV-positive patients with acute consciousness compromise

Cerebrospinal fluid syndromes in HIV-positive patients with acute consciousness compromise

Alternative title Síndromes liquóricas em pacientes HIV positivos com comprometimento agudo da consciência
Author Batista, Marcus Sabry Azar Autor UNIFESP Google Scholar
Sesso, Ricardo de Castro Cintra Autor UNIFESP Google Scholar
Reis-Filho, João Batista dos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract We reviewed the cerebrospinal fluid (CSF) syndromes of 100 consecutive HIV-positive patients presenting acute consciousness compromise in emergency rooms, and correlated them with clinical data. The most frequent CSF syndromes were: absolute protein-cytological dissociation (21), viral (19), neurocryptococcosis (7), relative protein-cytological dissociation (6) and septic (4), moderate hypoglycorrachia (4), severe hypoglycorrachia (4) and hydroelectrolytic disturbance (3). One fifth of the patients had CSF syndromes considered sufficient for diagnosis or an immediate clinical decision. The most common clinical data were infective and neurological. There was little correlation between the clinical data and the CSF syndromes. We conclude that in HIV-positive individuals presenting acute consciousness disturbances there are frequently non-specific results in the CSF analysis that must be weighed against a detailed history and thorough physical examination. Taking this into account, in about one fifth of cases the CSF analysis can offer useful information for treatment.

Revisamos as síndromes liquóricas de 100 pacientes HIV-positivos apresentando comprometimento agudo da consciência em pronto-socorro, as correlacionando com dados clínicos. As síndromes mais frequentes foram: dissociação proteino-citológica absoluta (21), viral (19), neurocriptococose (7), dissociação proteino-citológica relativa (6) e séptica (4), hipoglicorraquia moderada (4%), hipoglicorraquia severa (4%), distúrbio hidroeletrolítico (3%). Um quinto dos pacientes apresentou síndromes liquóricas consideradas suficientes para um diagnóstico ou uma conduta imediata. Os dados clínicos mais comuns foram infecciosos e neurológicos. Houve pouca correlação entre os dados clínicos e as síndromes liquóricas. Comparado a dados de literatura, HIV-positivos tem menor chance de resultados decisivos no exame de líquor. Nós concluimos que, em pacientes HIV-positivos, que se apresentam com alterações agudas da consciência, frequentemente há resultados inespecíficos no líquor, o que deve ser julgado em função de uma história clínica e exame físicos detalhados.
Keywords Cerebrospinal fluid
Delirium
Somnolence
AIDS
HIV
Líquor
Delirium
Sonolência
AIDS
HIV
Language English
Date 1999-12-01
Published in Revista da Sociedade Brasileira de Medicina Tropical. Sociedade Brasileira de Medicina Tropical - SBMT, v. 32, n. 6, p. 683-688, 1999.
ISSN 0037-8682 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Medicina Tropical - SBMT
Extent 683-688
Origin http://dx.doi.org/10.1590/S0037-86821999000600011
Access rights Open access Open Access
Type Article
SciELO ID S0037-86821999000600011 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/853

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