PEDIATRIC TIP The clinical course varies slightly in children, who have a shorter incubation time (mean, 17 months.) Signs and symptoms resemble those in adults, except for findings related to sexually transmitted disease (STD). Children show virtually all of the opportunistic infections observed in adults, with a higher incidence of bacterial infections: otitis media, pneumonias other than that caused by Pneumocystis carinii, sepsis, chronic salivary gland enlargement, and lymphoid interstitial pneumonia.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Kaposi's sarcoma:
Signs and symptoms
(Handbook of Diseases)
The initial sign of Kaposi’s sarcoma is one or more obvious lesions in various shapes, sizes, and colors (ranging from red-brown to dark purple) that appear most commonly on the skin, buccal mucosa, hard and soft palates, lips, gums, tongue, tonsils, conjunctivae, and sclerae.
With advanced disease, the lesions may join, becoming one large plaque. Untreated lesions may appear as large, ulcerative masses.
Other signs and symptoms include:
❑ a history of HIV infection
❑ pain (if the sarcoma advances beyond the early stages or if a lesion breaks down or impinges on nerves or organs)
❑ edema from lymphatic obstruction
❑ dyspnea (in cases of pulmonary involvement), wheezing, hypoventilation, and respiratory distress from bronchial blockage.
The most common extracutaneous sites are the lungs and GI tract (esophagus, oropharynx, and epiglottis).
Signs and symptoms of disease progression and metastasis include severe pulmonary involvement and GI involvement leading to digestive problems.
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Source: Handbook of Diseases, 2003
Human immunodeficiency virus infection:
Signs and symptoms
(Handbook of Diseases)
HIV infection manifests itself in many ways.
Clinical tip After a high-risk exposure and inoculation, the infected person usually experiences a mononucleosis-like syndrome, which may be attributed to the flu or another virus, and then may remain asymptomatic for years. In this latent stage, the only sign of HIV infection is laboratory evidence of seroconversion.
When symptoms appear, they may take many forms:
❑ persistent generalized adenopathy
❑ nonspecific symptoms (weight loss, fatigue, night sweats, fevers)
❑ neurologic symptoms resulting from HIV encephalopathy
❑ opportunistic infection or cancer.
The clinical course varies slightly in children with AIDS. Apparently, their incubation time is shorter, with a mean of 17 months. Signs and symptoms resemble those in adults, except for findings related to STDs. Children show virtually all of the opportunistic infections observed in adults, with a higher incidence of bacterial infections, such as otitis media, sepsis, chronic salivary gland enlargement, Mycobacterium avium complex function, and pneumonias, including Pneumocystis carinii and lymphoid interstitial pneumonias.
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Source: Handbook of Diseases, 2003
Chronic fatigue and immune dysfunction syndrome:
Signs and symptoms
(Handbook of Diseases)
The characteristic symptom of CFIDS is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms. To aid identification of the disease, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity. (See CDC criteria for diagnosing CFIDS.)
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Source: Handbook of Diseases, 2003
Human Immunodeficiency Virus Infection:
Human Immunodeficiency Virus Infection - signs & symptoms
(The 5-Minute Pediatric Consult)
Indications for HIV testing:
- Perinatal risk factors (e.g., prematurity, premature rupture of membranes, HIV testing in the mother)
- IV drug use
- Noninjectable drug use
- STDs, especially syphilis
- Bisexuality
- Transfusions before 1986
- Frequent infections
- Sinopulmonary infections
- Recurrent pneumonia/invasive bacterial disease
- Severe acute pneumonia (Pneumocystis)
- Recurrent or resistant thrush, especially after 12 months of age
- Congenital syphilis
- Presence of STDs in an adolescent
- Acquired microcephaly
- Progressive encephalopathy, loss of developmental milestones
- History of idiopathic thrombocytopenic purpura/thrombocytopenia
- Failure to thrive
- Recurrent/chronic diarrhea
- Recurrent/chronic enlargement of parotid gland
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Source: The 5-Minute Pediatric Consult, 2008
Acquired Hypothyroidism:
Acquired Hypothyroidism - signs & symptoms
(The 5-Minute Pediatric Consult)
- Early primary hypothyroidism can be asymptomatic.
- Hypothyroid-related symptoms indicate progression from compensated to uncompensated hypothyroidism.
- Hypothyroidism may be preceded in some cases by temporary hyperthyroidism (Hashitoxicosis).
- Goiter may be the presenting sign of acquired hypothyroidism; tenderness suggests an infectious process.
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Source: The 5-Minute Pediatric Consult, 2008
Community-acquired Pneumonia:
Presentation
(Pediatric Infectious Disease)
Recent reviews have suggested that the presence of an increased respiratory rate
may be the best method to distinguish lower respiratory tract infection from
the more common upper respiratory tract infections. The World Health
Organization has issued guidelines for the clinical diagnosis of pneumonia in
developing countries; the guidelines state that tachypnea and intercostal
retractions are the best indications of lower respiratory tract disease.
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Source: Pediatric Infectious Disease, 2004
Article Excerpts About Symptoms of HIV/AIDS:
Backgrounder - HIV Infection in Infants and Children: NIAID (Excerpt)
Many children with
HIV infection do not gain weight or grow normally. HIV-infected children
frequently are slow to reach important milestones in motor skills and
mental development such as crawling, walking and speaking. As the disease
progresses, many children develop neurologic problems such as difficulty
walking, poor school performance, seizures, and other symptoms of HIV
encephalopathy.
Like adults with HIV infection, children with HIV
develop life-threatening opportunistic infections (OIs), although the
incidence of various OIs differs in adults and children. For example,
toxoplasmosis is seen less frequently in HIV-infected children than in
HIV-infected adults, while serious bacterial infections occur more
commonly in children than in adults. Also, as children with HIV become
sicker, they may suffer from chronic diarrhea due to opportunistic
pathogens.
Pneumocystis carinii pneumonia (PCP) is the leading
cause of death in HIV-infected children with AIDS. PCP, as well as
cytomegalovirus (CMV) disease, usually are primary infections in children,
whereas in adults these diseases result from the reactivation of latent
infections.
A lung disease called lymphocytic interstitial
pneumonitis (LIP), rarely seen in adults, also occurs frequently in
HIV-infected children. This condition, like PCP, can make breathing
progressively more difficult and often results in hospitalization.
Children with HIV suffer the usual childhood bacterial infections
-- only more frequently and more severely than uninfected children. These
bacterial infections can cause seizures, fever, pneumonia, recurrent
colds, diarrhea, dehydration and other problems that often result in
extended hospital stays and nutritional problems.
HIV-infected
children frequently have severe candidiasis, a yeast infection that can
cause unrelenting diaper rash and infections in the mouth and throat that
make eating difficult. (Source: excerpt from Backgrounder - HIV Infection in Infants and Children: NIAID)
HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID (Excerpt)
Many people do
not have any symptoms when they first become infected with HIV. Some
people, however, have a flu-like illness within a month or two after
exposure to the virus. This illness may include fever, headache,
tiredness, and enlarged lymph nodes (glands of the immune system
easily felt in the neck and groin). These symptoms usually disappear
within a week to a month and are often mistaken for those of another
viral infection. During this period, people are very infectious, and
HIV is present in large quantities in genital fluids.
More
persistent or severe symptoms may not surface for a decade or more
after HIV first enters the body in adults, or within two years in
children born with HIV infection. This period of "asymptomatic"
infection is highly individual. Some people may begin to have
symptoms within a few months, while others may be symptom-free for
more than 10 years.
Even during the asymptomatic period, the
virus is actively multiplying, infecting, and killing cells of the
immune system. HIV's effect is seen most obviously in a decline in
the blood levels of CD4+ T cells (also called T4 cells) - the immune
system's key infection fighters. At the beginning of its life in the
human body, the virus disables or destroys these cells without
causing symptoms.
As the immune system deteriorates, a
variety of complications start to take over. For many people, their
first sign of infection is large lymph nodes or "swollen glands"
that may be enlarged for more than three months. Other symptoms
often experienced months to years before the onset of AIDS include
- lack of energy
- weight loss
- frequent fevers and sweats
- persistent or frequent yeast infections (oral or vaginal)
- persistent skin rashes or flaky skin
- pelvic inflammatory disease in women that does not respond to
treatment
- short-term memory loss
Some people develop frequent
and severe herpes infections that cause mouth, genital, or anal
sores, or a painful nerve disease called shingles. Children may grow
slowly or be sick a lot.
(Source: excerpt from HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID)
HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID (Excerpt)
Symptoms of
opportunistic infections common in people with AIDS include
- coughing and shortness of breath
- seizures and lack of coordination
- difficult or painful swallowing
- mental symptoms such as confusion and forgetfulness
- severe and persistent diarrhea
- fever
- vision loss
- nausea, abdominal cramps, and vomiting
- weight loss and extreme fatigue
- severe headaches
- coma
Children with AIDS may get the same opportunistic
infections as do adults with the disease. In addition, they also
have severe forms of the bacterial infections all children may get,
such as conjunctivitis (pink eye), ear infections, and tonsillitis.
People with AIDS are particularly prone to developing
various cancers, especially those caused by viruses such as Kaposi's
sarcoma and cervical cancer, or cancers of the immune system known
as lymphomas. These cancers are usually more aggressive and
difficult to treat in people with AIDS. Signs of Kaposi's sarcoma in
light-skinned people are round brown, reddish, or purple spots that
develop in the skin or in the mouth. In dark-skinned people, the
spots are more pigmented.
During the course of HIV
infection, most people experience a gradual decline in the number of
CD4+ T cells, although some may have abrupt and dramatic drops in
their CD4+ T-cell counts. A person with CD4+ T cells above 200 may
experience some of the early symptoms of HIV disease. Others may
have no symptoms even though their CD4+ T-cell count is below 200.
Many people are so debilitated by the symptoms of AIDS that
they cannot hold steady employment or do household chores. Other
people with AIDS may experience phases of intense life-threatening
illness followed by phases in which they function normally.
A small number of people (fewer than 50) first infected with
HIV 10 or more years ago have not developed symptoms of AIDS.
Scientists are trying to determine what factors may account for
their lack of progression to AIDS, such as particular
characteristics of their immune systems or whether they were
infected with a less aggressive strain of the virus, or if their
genes may protect them from the effects of HIV. Scientists hope that
understanding the body's natural method of control may lead to ideas
for protective HIV vaccines and use of vaccines to prevent the
disease from progressing.
(Source: excerpt from HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID)
HIV Infection in Women, NIAID Fact Sheet: NIAID (Excerpt)
Many manifestations of HIV disease
are similar in men and women. Both men and women with HIV may have
non-specific symptoms even early in disease, including low-grade
fevers, night sweats, fatigue, and weight loss. Anti-HIV therapies,
as well as treatments for other infections associated with HIV,
appear to be similarly effective in men and women. Other conditions,
however, occur in different frequencies in men and women.
HIV-infected men, for instance, are eight times more likely than
HIV-infected women to develop a skin cancer known as Kaposi's
sarcoma. In some studies, women had higher rates of herpes simplex
infections than men.
Data from several studies conducted by
NIAID's Terry Beirn Community Programs for Clinical Research on AIDS
(CPCRA) found that HIV-infected women were also more likely than
HIV-infected men to develop bacterial pneumonia. This finding may be
explained by factors such as a delay in seeking care among
HIV-infected women as compared to men, and/or less access to
anti-HIV therapies or preventive therapies for Pneumocystis carinii
pneumonia (PCP). (Source: excerpt from HIV Infection in Women, NIAID Fact Sheet: NIAID)
HIV Infection in Women, NIAID Fact Sheet: NIAID (Excerpt)
Women also
experience HIV-associated gynecologic problems, many of which occur
in uninfected women but with less frequency or
severity.
Vaginal yeast infections, common
and easily treated in most women, often are particularly persistent
and difficult to treat in HIV-infected women. Data from WIHS suggest
that these infections are considerably more frequent in HIV-infected
women. A drug called fluconazole is commonly used to treat yeast
infections. A CPCRA study demonstrated that weekly doses of
fluconazole can also safely prevent oropharyngeal and vaginal but
not esophageal yeast infections, without resulting in resistance to
the drug.
Other vaginal infections may occur
more frequently and with greater severity in HIV-infected women,
including bacterial vaginosis and common STDs such as gonorrhea,
chlamydia, and trichomoniasis.
Severe herpes simplex
virus ulcerations, which are sometimes unresponsive to
therapy with the standard drug acyclovir, can severely compromise a
woman's quality of life.
Idiopathic genital
ulcers, with no evidence of an infectious organism or
cancerous cells in the lesion are a unique manifestation of HIV
disease. These ulcers, for which there is no proven treatment, are
sometimes confused with those caused by herpes simplex virus.
Human papillomavirus (HPV) infections,
which cause genital warts and can lead to cervical cancer, occur
with increased frequency in HIV-infected women. A precancerous
condition associated with HPV, called cervical dysplasia, is also
more common and more severe in HIV-infected women, and more apt to
recur after treatment.
Pelvic inflammatory disease
(PID) appears to be more common and more aggressive in
HIV-infected women than in uninfected women. PID may become a
chronic and relapsing condition as a woman's immune system
deteriorates.
Menstrual irregularities
frequently are reported by HIV-infected women and are being actively
studied by NIAID-supported scientists. Although menstrual
irregularities were equally common in HIV-infected women and at-risk
HIV-negative women in a WIHS survey, women with CD4+ T-cell counts
below 50 per cubic millimeter (mm3) of blood were more likely to
report no periods than were uninfected women, or HIV-infected women
with higher CD4+ T-cell counts. (Source: excerpt from HIV Infection in Women, NIAID Fact Sheet: NIAID)
Women and HIV-AIDS: NWHIC (Excerpt)
Symptoms that could serve as warning signals of HIV infection may go
ignored because many women do not perceive themselves at risk. Symptoms
include recurrent yeast infections (vaginal candidiasis), pelvic
inflammatory disease, abnormal changes or dysplasia (growth and presence
of precancerous cells) in cervical tissue, genital ulcers, genital warts,
and severe mucosal herpes infections may also accompany HIV infection in
women.
It is possible for a person infected with HIV to show no signs of
infection. For women, the most common symptoms of exposure to the HIV
virus are frequent or severe vaginal infections, abnormal PAP smears, or
pelvic infections (PID) that are difficult to treat.
Within a few weeks of having been infected, many people have flu-like
symptoms. However, in some cases, symptoms do not show for many years. As
the infection progresses, some symptoms can include 1) swollen lymph
glands in the neck, underarm, or groin area, 2) recurrent fever including
"night sweats," 3) rapid weight loss for no apparent reason, 4) constant
tiredness, 5) diarrhea and decreased appetite, 6) white spots or unusual
blemishes in the mouth.
(Source: excerpt from Women and HIV-AIDS: NWHIC)
HIV, AIDS, and Older People - Age Page - Health Information: NIA (Excerpt)
Many people do not have any symptoms when they are first infected
with HIV. It can take as little as a few weeks for minor flu-like
symptoms to show up or as long as 10 years or more for more serious
symptoms. Symptoms can include headache, chronic cough, diarrhea,
swollen glands, lack of energy, loss of appetite and weight loss,
frequent fevers and sweats, frequent yeast infections, skin rashes,
pelvic and abdominal cramps, sores on certain parts of your body,
and short-term memory loss. People age 50 and older may not
recognize HIV symptoms in themselves because they think what they
are feeling and experiencing is part of normal aging. (Source: excerpt from HIV, AIDS, and Older People - Age Page - Health Information: NIA)
HIV/AIDS as a Cause of Symptoms or Medical Conditions
When considering symptoms of HIV/AIDS, it is also important to consider HIV/AIDS as a possible cause of other medical conditions.
The Disease Database lists the following medical conditions that HIV/AIDS may cause:
- (Source - Diseases Database)
The treatment of HIV can be very complex with medicines that have to be taken several times a day. Now there are medicines that can be taken once a...
In an effort to keep pace with new treatments and clinical practice, the government convenes a panel of experts to develop recommendations for the...
When people with HIV have good access to health care, they can expect to live long and well. That's because doctors have learned to combine drugs...
Lipodystrophy is a condition that many people with HIV develop. Their appearance can change dramatically and they may experience dangerous...