ABSTRACT
Vitamin A administered to children infected with the human immunodeficiency virus before influenza vaccination in a double-blind randomized study did not enhance vaccine serologic responses but did dampen the increase in the human immunodeficiency virus viral load 14 days after immunization (vitamin A, decrease of 0.13 +/- 0.09 log(10) copies/mL; placebo, increase of 0.14 +/- 0.08, P =.02).
Subject(s)
Antibodies, Viral/drug effects , HIV Infections/immunology , HIV Infections/virology , HIV-1 , Influenza A virus/immunology , Influenza B virus/immunology , Influenza Vaccines/immunology , Viral Load , Vitamin A/administration & dosage , Adolescent , Antibodies, Viral/blood , Child , Child, Preschool , Double-Blind Method , Female , Humans , Male , Time Factors , Vaccines, Inactivated/immunologyABSTRACT
Symptoms and laboratory evidence of adrenal suppression developed in 2 children with the human immunodeficiency virus after megestrol acetate (MA) therapy was discontinued; both required transient glucocorticoid replacement therapy. High-dose corticotropin stimulation testing performed on children with the human immunodeficiency virus treated or not treated with MA showed that baseline and post-corticotropin cortisol levels were extremely low in 7 of 10 treated patients and normal in 10 of 10 members of a control group (P <.01). MA may suppress adrenal function, and replacement glucocorticoids may prevent or relieve associated symptoms at times of severe stress or on discontinuation of MA therapy.
Subject(s)
Adrenal Insufficiency/etiology , Appetite Stimulants/therapeutic use , HIV Infections/complications , HIV-1 , Megestrol Acetate/therapeutic use , Adrenal Insufficiency/blood , Adrenal Insufficiency/diagnosis , Adrenocorticotropic Hormone , Appetite Stimulants/adverse effects , Chi-Square Distribution , Child , Child, Preschool , Female , HIV Infections/blood , HIV Infections/drug therapy , Humans , Hydrocortisone/blood , Male , Megestrol Acetate/adverse effects , Statistics, Nonparametric , Substance Withdrawal Syndrome/blood , Substance Withdrawal Syndrome/diagnosisABSTRACT
We describe two children with human immunodeficiency virus infection in whom pyoderma gangrenosum developed. Although pyoderma gangrenosum most commonly occurs in children with inflammatory bowel disease, it has also been described in patients with a variety of immunodeficiencies. In such patients a vigorous search to exclude a treatable infection should be made before the lesions are treated as pyoderma gangrenosum.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Pyoderma/complications , Child, Preschool , Ear, External/pathology , Female , Gangrene , Humans , Infant , Male , Perineum/pathology , Pyoderma/pathology , Ulcer/pathologyABSTRACT
Ceftriaxone has greater in vitro and in vivo efficacy against many common bacteria than other third-generation cephalosporins. Single-dose ceftriaxone pharmacokinetics were studied in 17 patients, aged 0.6 to 52 months, with infections of the central nervous system. Patients received a randomized dose of 50 or 75 mg/kg ceftriaxone intravenously over 5 minutes on the second to fifth day of illness. Serial blood samples were collected over 24 hours in all patients, and cerebrospinal fluid (CSF) was obtained 1 to 4.5 hours after injection. Ceftriaxone mean peak plasma concentrations, determined by high-power liquid chromatography, were 267 and 184 microgram/ml for the 75 and 50 mg/kg dosage groups, respectively. The harmonic mean elimination half-life was 4.2 hours, and the mean percent drug penetrance into CSF was 4.8 +/- 3.5%. Of CSF studies evaluated, the glucose concentration was correlated most closely (inversely) with CSF penetration of ceftriaxone. Individual CSF concentrations of ceftriaxone exceeded the minimal inhibitory concentrations of the respective bacteria causing infection by 480 to 5,600 times. Ceftriaxone may be useful in the treatment of serious pediatric infections, including meningitis.