Musculoskeletal symptomatology in some HIV-positive injecting drug users may be a manifestation of the benzodiazepine withdrawal syndrome.
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Biomedical subjects
Publications and source records attributed to D H Kennedy.
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A wide variety of pathologies afflicting the genitourinary tract can be displayed by patients infected with the human immunodeficiency virus (HIV), including both infective and neoplastic conditions. Treatment can often be offered for such conditions using a combination of therapeutic approaches. These conditions should be looked for specifically in patients with HIV infection as treatment may improve their quality of life. A case is presented of a testicular seminoma (appearing in association with an intracranial mass and Kaposi's sarcoma) in a male patient with the acquired immune deficiency syndrome (AIDS); he made a good response to orchiectomy and radiotherapy for his seminoma. A short review is also given of the range of HIV-associated genitourinary pathologies which have been described to date.
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A 14-year-old boy with psittacosis who developed skin lesions consistent with erythema marginatum is reported. This association has not been described previously.
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A fatal case of common variable hypogammaglobulinaemia (CVH) is described. The patient presented with fulminant haemolytic anaemia. Post mortem examination revealed evidence of chronic hypogammaglobulinaemia.
The viability of a programme for delivering aerosolized pentamidine within the patient's home setting for the secondary prophylaxis of Pneumocystis carinii pneumonia (PCP) has been explored with seven homosexual AIDS patients, the major objectives being the assessment of the safety and acceptability of the treatment and the discovery of the most suitable care setting (home, ward, outpatient clinic) for the administration of therapy. It is concluded that a domiciliary prophylaxis programme is a viable alternative.
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A man with AIDS is described in whom a profound weight loss was converted into a weight gain by treatment with megoestrol acetate, a synthetic progesterone. His appetite improved and was accompanied by a feeling of improved well-being. Following abrupt discontinuation of the drug, there was a significant but transient depression of mood and appetite associated with loss of energy; it is suggested that this complex of symptoms might represent a megoestrol acetate withdrawal-associated syndrome.
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Four women with tuberculous meningitis in association with pregnancy are described to illustrate both the serious nature and varied presentation of this condition. Mortality or neurological morbidity may occur more frequently during pregnancy, but in general correlate closely with delay in diagnosis and initiation of appropriate therapy. Treatment often needs to be started empirically, and neurosurgical intervention may prove life saving.
A case of acute mucosal ulceration of the entire small intestine accompanied by skin rash, hepatitis and marrow suppression is reported. Recovery was complicated by a severe protein losing enteropathy and small intestinal strictures and the patient died post-operatively of a pulmonary embolism. The aetiology remains unknown.