       Document 0019
 DOCN  M9620019
 TI    Clinical correlates of secondary meningitis in HIV-infected adults.
 DT    9602
 AU    Friedmann PD; Samore MH; Kraemer KL; Calkins DR; Division of General
       Internal Medicine, Deaconess Hospital,; Boston, Mass., USA.
 SO    Arch Intern Med. 1995 Nov 13;155(20):2231-7. Unique Identifier :
       AIDSLINE MED/96048974
 AB    BACKGROUND: Neurologic complaints are common in adults infected with the
       human immunodeficiency virus, but little is known about which clinical
       features are associated with secondary causes of meningitis. METHODS: A
       retrospective cross-sectional study of adults infected with the human
       immunodeficiency virus who received a diagnostic lumbar puncture (LP) in
       the infectious disease clinic, emergency department, and inpatient wards
       of the Deaconess Hospital, Boston, Mass, from 1989 through 1992 to
       determine which clinical features available at the time of LP are
       correlated with definite or probable secondary meningitis. RESULTS: Of
       the 491 LPs, 90% were performed in whites, 93% in men, and 11% in
       injection drug users. Cerebrospinal fluid test results revealed
       secondary meningitis in 39 (7.9%) of 491 LPs performed on 322
       individuals. Cryptococcal meningitis was the predominant type (27
       cases); no bacterial or tuberculous meningitis was found. In
       multivariate analyses, a history of non-Hodgkin's lymphoma (adjusted
       odds ratio [OR], 4.3; 95% confidence interval [CI], 1.5 to 12.5), a
       history of herpes simplex virus infection (OR, 2.5; 95% CI, 1.2 to 5.0),
       nausea and/or vomiting (OR, 2.0; 95% CI, 1.03 to 4.0), headache in a
       person with the acquired immunodeficiency syndrome (OR, 2.1; 95% CI,
       1.03 to 4.4), and cranial nerve abnormalities (OR, 5.1; 95% CI, 1.8 to
       14.1) were positive correlates of opportunistic meningitis; current
       fluconazole use (OR, 0.3; 95% CI, 0.1 to 0.8) conferred a lower risk.
       CONCLUSION: In similar clinical settings, physicians and their human
       immunodeficiency virus-infected patients should consider these features
       when assessing the risk of secondary meningitis and the necessity for
       immediate LP.
 DE    Adult  *AIDS-Related Opportunistic Infections  Cross-Sectional Studies
       Female  Human  HIV Infections/COMPLICATIONS  Male  Meningitis/*VIROLOGY
       Prevalence  Retrospective Studies  Sensitivity and Specificity  Spinal
       Puncture  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

