Document 2894
 DOCN  M94A2894
 TI    Persistent neutrophilic meningitis in patients with AIDS.
 DT    9412
 AU    Roca V; Sanchez-Portocarrero J; Martin T; Perez-Cecilia E; de la Torre
       F; Picazo JJ; Fernandez-Cruz A; Hospital Universitario San Carlos,
       Madrid, Spain.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):200 (abstract no. PB0230). Unique
       Identifier : AIDSLINE ICA10/94369681
 AB    We report five cases of Persistent Neutrophilic Meningitis (PNM),
       diagnosed in base of case-definition criteria proposed by J. E. Peacock
       (persistent neutrophilic pleocytosis in CSF for more than 7 days,
       despite to be treated with appropriate antimicrobial regime), and
       accounted in patients with HIV-infection. In 4 the responsible
       etiological microorganism of PNM was M. tuberculosis and one it was C.
       albicans. All were parenteral drug addicts (4 man y 1 women) with
       severely impaired immunity: CD4+ lymphocyte count were below of 100 by
       milliliter in four of them. Three of four patients with M. tuberculosis
       meningitis had been previously diagnosed and incompletely treated (due
       to self-discontinuation) with 4 drugs (isoniazid, rifampin, ethambutol
       and pyrazinamide) for an episode of pulmonary or disseminated
       tuberculosis. Headache was the more constant symptom, present in all.
       Fever was present in only 4, stiff neck in 3/5, CT alterations in 3/5,
       nausea and or vomiting in 2/5, obnubilation or cognitive impairment 2/5
       and another infection of central nervous system (toxoplasmosis) in 1/5.
       So, we think that the concept of PNM is a good predictor of etiological
       responsible agent of meningitis, and, in our geographic area, is closely
       and more frequently related, in HIV-positive patients, with M.
       tuberculosis.
 DE    Antitubercular Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/DRUG THERAPY/*PATHOLOGY  Candidiasis/DRUG THERAPY/*PATHOLOGY
       Female  Human  Leukocyte Count  Male  Meningitis, Fungal/DRUG
       THERAPY/*PATHOLOGY  *Neutrophils  Substance Abuse,
       Intravenous/COMPLICATIONS  Tuberculosis, Meningeal/DRUG
       THERAPY/*PATHOLOGY  T4 Lymphocytes  MEETING ABSTRACT

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