疾病名称

疾病概述

疾病分类

疾病描述

症状体征

疾病病因

病理生理

诊断检查

治疗方案

疾病预防

安全提示

Otorhinolaryngologic AIDS
Contents
The names of diseases
Disease overview
Classification of Diseases
Disease described
Signs and symptoms
Disease etiology
Pathophysiological
Diagnostic tests
• treatment programs
• disease prevention
• Safety Tips
The names of diseases
Otorhinolaryngologic AIDS
Disease overview
AIDS, also known as acquired immunodeficiency syndrome, 1981 was a new awareness of sexually transmitted diseases, AIDS since been found, spreads rapidly and has become a worldwide endangering human health and social development seriously disease. AIDS is caused by human immunodeficiency virus infectious diseases, HIV infection, a disease spectrum, from the clinical progress of latent or asymptomatic to advanced performance for AIDS.
Classification of Diseases
ENT
Disease described
AIDS (AIDS) or Acquired Immune Deficiency Syndrome, Primary Central Africa, is the first in the United States in 1981 and then in other countries, a serious epidemic lethal viral diseases, that ended in December 1994, has been about 170 countries to the WHO report on AIDS cases, about 17 million people infected with HIV, 400 million people have the disease, has been more than 200 million people die of AIDS. The number of HIV infection and morbidity is still rapid growth of the number of trends, since Beijing in 1985 found the first case of AIDS (the Americans) until only the end of December 1994, mainland China's HIV-positive has reached 1774 cases, of which AIDS were 65 cases, 45 deaths, patients in 22 mainland provinces, municipalities and autonomous regions, shows that the trend of China's AIDS epidemic is quite serious, the disease occurs mainly in homosexuals, more men than women, but in recent years, women and children for AIDS those infected before birth increased significantly: men and women in Brazil in 1986 the proportion of AIDS patients is 17:1,1993 year it rose to 4:1, the United States has reached 2:1, the age of the vast majority in the 20-49 years old.
Signs and symptoms
From HIV infection to the development of AIDS may be going through three different periods of time.
1, since the incubation period of several months to several years, infected persons were found in serum anti-HIV antibodies, but no clinical symptoms.
2, lymph node-related syndrome (LAS) or that AIDS-related syndrome (ARC), that is pre-AIDS, sustainable one to many years, manifested in many parts of the body a number of lymph nodes in the groin at least two outside lymph nodes, continuing for more than 3 months, repeatedly sustained fever, diarrhea, fatigue, weight loss, night sweats, weight loss, idiopathic thrombocytopenic Purpura, lymphocytes and Leukopenia, Th / Ts ratio decreased.
3, AIDS period of performance opportunities for serious infections, which in normal circumstances do not cause disease pathogens, including viruses, fungi and protozoa Mycobacterium, because patients with immune deficiency and infection, such as pneumocystis carinii pneumonia (PCP ) or cytomegalovirus infection, etc., as well as some rare mid-stream, such as Kaposi sarcoma (KS) and other non-Hodgkin's lymphoma. Kaposi sarcoma appears the average survival time of patients with about 18 months. According to the first time in newly diagnosed disease symptoms found in statistics, the percentage is: extensive lymph node disease accounted for 72%, Kaposi's sarcoma was 40%, hair-like disease Leukoplakia 39%, 31% candidiasis, neck mass of 8%, herpes simplex 7%. About 25% of HIV-positive lymph nodes developed into a related syndrome, about 10% to develop into AIDS.
AIDS in Otolaryngology - Head and Neck AIDS about the performance of 40% -70% of Otolaryngology - Head and neck lesions.
1, ear Kaposi sarcoma lesions for multiple hemorrhagic sarcoma, can occur in the outer ear, the performance of red purple patch or nodule, the outer ear infection pneumocystis carinii cyst for multi-core, pathological examination can be found in protozoa, stare聍has not yet been found that the virus, but can be separated from the middle ear effusion of HIV, the middle ear can be seen in agriculture, culture fungi, protozoa, viruses or the distribution of bacteria, HIV easily violate the central nervous system or auditory nerve, early sensorineural hearing loss more often See.
2, nose and paranasal sinuses and nasal mucous membrane lesions may be due to parasites such as Entamoeba mucosal swelling caused by infection, resulting in a stuffy nose, runny or脓涕symptoms such as nasal bleeding, nose of the herpes virus infection may have a great herpes ulcer, since nasal vestibule expansion to neighboring nose, etc., KS may also occur in the nose.
3, oral and throat lesions of the mouth and pharynx moving Candida is the most common upper respiratory tract disease, found in the ventral tongue can also occur in the pharynx or esophagus, causing pharyngodynia and swallowing difficulties, lesions table will leave membrane formation, except pseudome wound can be seen rough like erythema, which can produce toxins and enzymes inside, penetrate deeper affected mucosa, hair-like Leukoplakia is commonly found in the tongue or the side of the ventral margin for crassa white processes, multi-fixation in the epithelial surface, it is reported that in the hairs Leukoplakia-like disease after diagnosis, 48% of patients in 16 months the development of AIDS, 83% of patients in 31 months the development of AIDS, and sometimes we can see a white throat cheese kind of fungal infection, and form part of obstruction, mucosa can fungi often stimulated diagonalization, showing the kind of rough spot performance, by microscopic examination or fungal culture can be diagnosed. AIDS made by tonsil bacteria, Mycoplasma pneumoniae and Chlamydia trachomatis, etc. arising. KS often occurred in the palate, buccal, gingival mucosa and pharyngeal wall, KS and Candida infections can also occur in the throat, causing hoarseness, throat and laryngeal stridor obstruction.
4, neck lesions of cervical lymph node disease is one of the early symptoms, as a result of HIV infection resulted in follicular hyperplasia, often cervical lymphadenopathy, KS can occur in the head and neck skin, when its violations of lymph nodes, the cervical lymph node can be increased rapidly , neck mass should also consider non-Hodgkin's lymphoma and infection, such as distribution. Fine-needle aspiration biopsy (FNAB) contribute to the diagnosis and differential diagnosis. P-cell head and neck cancer more often in AIDS patients, other infections can also be caused by a virus such as the parotid gland swelling and so on.
Disease etiology
Allergens for the human immunodeficiency virus, also known as type Ⅱ pro-retroviral human T cells have now found that the most common variant of HIV-Ⅰ, (there are sub-species) and almost exclusively in West Africa to see HIV -2. HIV violations of human T lymphocytes, mainly T helper cell (Th), in which the propagation and caused his death, as Th reduced inhibitory T cells (Ts) will be relatively increased, Th / Ts reverse ratio (normal value of 1.6 -2.1), showing inhibition of immune function, leading to immune deficiency, so that a wide range of human pathogens lose defense capabilities cathode various opportunistic infection, and infection makes immunodeficiency further increase, resulting in immune deficiency, a vicious cycle of infection, immune function even lower, and even loss. HIV exists in AIDS patients and HIV-infected blood, semen, milk, saliva, tears and other body fluids, its modes of transmission are mainly three kinds:
(1) sexual contact, the virus can be disastrous homosexual and heterosexual spread of between.
(2) the blood channels, intravenous injection, blood transfusion and blood products, use or sharing of contaminated syringes, may become infected channels.
(3) mother to child transmission, the mother of HIV in the blood to the placenta to the fetus, or through breast milk to their infants and young children, the newborn is generally believed that AIDS is in an advanced stage of pregnancy or childbirth from the mother to the process of. With AIDS in the daily lives of ordinary contact, such as by the same car, living room reunification will not be borne, so far, there is no evidence that HIV may be nationals of air, insects, the spread of food.
Pathophysiological
Allergens for the human immunodeficiency virus, also known as type Ⅱ pro-retroviral human T cells (HTLV-Ⅱ) is now found to have a variant that is the most common HIV-Ⅰ, (there are sub-species) and almost exclusively in Africa west to see HIV-2. HIV violations of human T lymphocytes, mainly T helper cell (Th), in which the propagation and caused his death, as Th reduced inhibitory T cells (Ts) will be relatively increased, Th / Ts reverse ratio (normal value of 1.6 -2.1), showing inhibition of immune function, leading to immune deficiency, so that a wide range of human pathogens lose defense capabilities cathode various opportunistic infection, and infection makes immunodeficiency further increase, resulting in immune deficiency, a vicious cycle of infection, immune function even lower, and even loss. HIV exists in AIDS patients and HIV-infected blood, semen, milk, saliva, tears and other body fluids, its modes of transmission are mainly three kinds: (1) sexual contact, the virus can be disastrous homosexuality and heterosexuality person among dissemination. (2) the blood channels, intravenous injection, blood transfusion and blood products, use or sharing of contaminated syringes, may become infected channels. (3) mother to child transmission, the mother of HIV in the blood to the placenta to the fetus, or through breast milk to their infants and young children, the newborn is generally believed that AIDS is in an advanced stage of pregnancy or childbirth from the mother to the process of. With AIDS in the daily lives of ordinary contact, such as by the same car, living room reunification will not be borne, so far, there is no evidence that HIV may be nationals of air, insects, the spread of food.
Diagnostic tests
Including clinical and laboratory examination:
(1) shows the history of consultation, such as whether or not been to or from the AIDS epidemic and sexual confusion in the history of the region, whether or not the history of drug abuse or accept blood transfusions or blood products.
(2) unusual opportunistic infection such as pneumocystis carinii pneumonia or some specificity of tumors such as KS, this is an important diagnostic basis, generalized lymphadenopathy and the mouth, pharynx and other Candida infections, AIDS appears to be precursors, should be noted.
(3) laboratory tests: AIDS blood Th / Ts ratio of less than 1, using enzyme-linked immunosorbent assay (ELISA) detection of HIV antibodies, HIV infection usually about two months, you can identify the antibody, but the next body-positive only about 10% of AIDS, and there is 1.4% -2% for the false positive, so this must be the basis of screening with clinical analysis, and follow-up observation and, if necessary, can be used for more specific of the Western blot test.
Treatment programs
There is no specific treatment, should focus on the pathogenesis of the virus, cellular immune function in the destruction of opportunistic infection and tumor formation of the four active treatment measures, AZT can increase the human body to prevent infection in the number of CD4 cells, inhibit HIV, the newly discovered AZT can significantly reduce the vulnerability of HIV-infected pregnant women will be opportunities for pathogens to the fetus, but the larger of its toxicity, should not be taken individually, to the asymptomatic and mild symptoms were taking zidovudine, can delay the occurrence of AIDS, but its role is temporary, heterogeneous polyanions -23 and Ribavirin, such as inhibiting HIV, have little effect. R interferon beta, IL-α, thymus hormones, transfer factor, or bone marrow transplantation, such as the reconstruction of immune function despite much progress, the use of targeted drug therapy opportunistic infection, such as pneumocystis carinii pneumonia available trimethoxybenzaldehyde BAI, isoxazole Sulfamethoxazole, dapsone and so on, cytomegalovirus infection ganciclevir available or AZT treatment, acyclovir for the treatment of herpes virus infections, fungal available amphotericin B, ketoconazole, etc.. However, because patients with immune deficiency and physical weakness and other factors, often side effects or allergic reactions, they are difficult to reach the desired results, mouth, pharynx, head and neck of KS may be surgically removed, and radiation therapy or the Arab-Israeli toxins, VCR, etc. chemotherapy, to be received by a certain effect, are more a result of the treatment of reaction or side effects of continued treatment, code-named RGP120MN and RGP120SF-2 of the two vaccines in clinical trial will start, but its effect is expected difficult choice to adjust the body acupuncture and Chinese medicine balance, and enhance immunization, at the same time plus antiviral medicines, taken by the dialectical method of diagnosis and treatment analysis of the unique conditions, the implementation of individual treatment has also been made by means of some effect. AIDS in poor prognosis, the current World Health Organization and many countries are actively exploring effective prevention methods, today's focus should also pay close attention to preventive work.
Disease Prevention
Strengthen health education, and enhance self-protection ability of the public to prevent the transmission of the source of the invasion, cutting off transmission, risk groups is to prevent AIDS stretches of three main components, namely, to strengthen the quarantine of blood and its products strict detection and management, HIV-positive who should be barred from blood, organs or other organizations, female patients should avoid pregnancy, to prevent HIV-infected persons with blood, semen, urine, excrement, saliva, tear, sputum or vaginal secretions, such as contacts, do not share toothbrushes, razors such as appliances, medical supplies, such as injection of as much as possible to take a one-time use, the recovery should take strict disinfection and medical personnel if there is skin lesions should avoid contact with AIDS, crack down on drug abuse, prostitution and other activities. The degree of risk groups, such as long-term testing. Otorhinolaryngology more medical personnel may come into contact with AIDS patients pus, saliva, body fluids and blood, with the operating room in the clinic should take strict precautions to inspect the operation or treatment should be wearing隔离衣, wearing protective glasses , respirators or masks, as well as new gloves or double gloves, equipment and materials used are strictly sterilized or incineration emissions.
Safety Tips
Often the first AIDS diagnosis in otorhinolaryngology, the clinical symptoms and more non-specific, so otorhinolaryngology doctors should be on high alert, to conduct a comprehensive inspection, timely diagnosis.
AIDS prevention is still no effective cure, vaccine being studied, so prevention is the most important.
1. Universal access to AIDS prevention and basic knowledge, understanding of its route of transmission, the main clinical manifestations and protective measures.
2. Strengthening the quarantine work, the use of blood and its products must be detected by HIV. To strengthen the border quarantine, to prevent AIDS Habitat everyone.
3. The prohibition of HIV-positive blood, organs and other organizations, female patients should avoid pregnancy.
4. To avoid HIV infection, AIDS patients and high risk sexual contacts, promote the use of condoms.
5. Do not share toothbrushes, razors, etc. may be blood contaminated items.
6. As far as possible the use of disposable medical injection products, the recovery should take strict disinfection.
7. Medical personnel in contact with HIV-infected people, AIDS patients with the blood, body fluids should pay attention to protection. Has been severely crack down on drug abuse, prostitution and other activities, on the high-risk groups, such as long-term monitoring.
8. Crack down on drug abuse, prostitution and other activities, on the high-risk groups, such as long-term monitoring.
References:
1.http: / / www.yongyao.net / jbhtml / ebyhazb.htm