Skip to main content

Advertisement

Log in

HIV infection mimicking autoimmune disorder

  • Clinical Brief
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

A 13-yr-old girl born to healthy parents presented with cough, fever, easy fatiguability, photosensitivity and alopecia. She had clubbing and diffuse crackles in the chest on examination. Her CT scan of the chest showed evidence of bronchiectasis with consolidation. Investigations for tuberculosis and collagen vascular disease were negative. In due course she developed features of raised intracranial tension. Her blood for HIV ELISA was positive with CD4 counts of 17/μL. Her CSF, sputum, blood and urine specimen were all positive for Cryptococcus neoformans on culture. HIV was not considered initially because of her atypical presentation. There was no history of sexual abuse, her parents were healthy and she did not receive any blood transfusion in the past.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Maurer TA. Dermatologic manifestatations of HIV. Top HIV Med 2006; 13: 149–154.

    Google Scholar 

  2. Schreckenberg C, Lipsker D, Petiau P, Heid E, Grosshans E. Photosensitivity as presenting sign of HIV infection. Control with triple antiretroviral therapy. Ann Dermatol Venereol 1998; 125: 516–518.

    PubMed  CAS  Google Scholar 

  3. Vinchristian K, Epstein JH, Maurer TA et al. Photosensitivity in HIV-infected individuals. J Dermatol 2000; 27: 361–369.

    CAS  Google Scholar 

  4. Stewart MI, Smoller BR. Alopecia universalis in an HIV-positive patient: possible insight into pathogenesis. J Cutan Pathol 1993; 20: 180–3.

    Article  PubMed  CAS  Google Scholar 

  5. Wanchu A. HIV Infection: Rheumatic manifestations. J Indian Rheumatol Assoc 2003; 11: 121–130.

    Google Scholar 

  6. Marisa SK, Michael LM. Systemic Lupus Erythematosus In Behrman, Kliegman, Jenson, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia; Elsevier, 2004; 809.

    Google Scholar 

  7. Mirken B. HIV Skin Complications in the Age of HAART. Bulletin of Experimental Treatments for AIDS, Year-End, 1999. http://www.sfaf.org/treatment/beta/b42/b42 skin-complications.html .

  8. Lodha R, Upadhyaya A, Kapoor V, Kabra SK. Clinical features and natural history of children with HIV infection. Indian J Pediatr 2006; 73: 201–204.

    PubMed  Google Scholar 

  9. Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg K. Review of human immunodeficiency virus type-1 related opportunistic infections in sub-Saharan Africa. Clin Infect Dis 2003; 36: 652–662.

    Article  PubMed  Google Scholar 

  10. Tihana B, Thomas SH. Cryptococcal meningitis. Brit Med Bull 2004; 72: 99–118.

    Google Scholar 

  11. Mitchell DH, Sorrell TC, Allworth AM et al. Cryptococcal diseases of the CNS in immunocompetent hosts: influence of cryptococcal variety on clinical manifestations and outcome. Clin Infect Dis 1995; 20: 611–616.

    PubMed  CAS  Google Scholar 

  12. Jeng JH, Liang SO, Wen IL, Jing LH. Central nervous system infections in patients with Systemic lupus erythematosus. J Rheumatol 2005; 32: 40–43.

    Google Scholar 

  13. Murray W, Cryptococcosis In Feigin RD, Cherry JD, Demmler GJ, Kaplan S, eds. Textbook of Pediatric Infectious Diseases. 3rd ed, WB Saunders, Philadelphia; 1992; 1934.

    Google Scholar 

  14. Van der horst CM, Saag MS, Cloud GA et al. Treatment of cryptococcal meningitis associated with the acquired immunodeficiency syndrome. N Engl J Med 1997; 337: 15–21.

    Article  PubMed  Google Scholar 

  15. Robinson PA, Bauer M, Leal ME et al. Early mycological treatment failure in AIDS-associated cryptococcal meningitis. Clin Infect Dis 1999; 28: 82–92.

    PubMed  CAS  Google Scholar 

  16. Chuck SL, Sande MA. Infection with Cryptococcus neoformans in the acquired immunodeficiency syndrome. N Engl J Med 1989; 321: 794–799.

    Article  PubMed  CAS  Google Scholar 

  17. Saag MS, Graybill RJ, Larsen RA et al. For the MSG cryptococcal subproject practice guidelines for the management of cryptococcal disease. Clin Infect Dis 2000; 30: 710–718.

    Article  PubMed  CAS  Google Scholar 

  18. Macsween K, Bicanic T, Brouwer AE, Marsh H. Macallan DC, Harrison TS. Lumbar drainage in control of cerebrospinal fluid pressure in cryptococcal meningitis: Case report and review. J Infect 2005; 51: e221–e224.

    Article  PubMed  Google Scholar 

  19. Newton PN, Thai LH, Tip NQ et al. A Randomized, double blind, placebo controlled trial of acetazolamide for the treatment of elevated intracranial pressure in cryptococcal meningitis. Clin Infect Dis 2002; 35: 769–772.

    Article  PubMed  CAS  Google Scholar 

  20. Graybill JR, Sobel J, Saag MS et al. Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. Clin Infect Dis 2000; 30: 47–54.

    Article  PubMed  CAS  Google Scholar 

  21. Jenny-Avital ER, Abadi M. Immune reconstitution cryptococcosis after initiation of successful highly active anti retroviral therapy. Clin Infect Dis 2002; 35: e128–e133.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. K. Kabra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sankar, J., Raj, D., Sankar, J. et al. HIV infection mimicking autoimmune disorder. Indian J Pediatr 74, 777–780 (2007). https://doi.org/10.1007/s12098-007-0139-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-007-0139-2

Key words

Navigation