Related Experiment Videos
Patterns of presentation of human immunodeficiency virus type 1-infected children to the paediatric surgeon
1Department of Paediatric Surgery, University of Natal, Durban, South Africa.
Insights
Pediatric surgical units see many human immunodeficiency virus type 1 (HIV-1) infections, with infections being the most common presentation. Many children were asymptomatic, highlighting the need for surgical awareness of HIV-1.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Immunology
Background:
- Human immunodeficiency virus type 1 (HIV-1) infection presents unique challenges in pediatric surgical care.
- Early recognition and management are crucial for improving outcomes in children with HIV-1.
Purpose of the Study:
- To determine the presentation patterns of HIV-1 infected children at a pediatric surgical unit.
- To analyze the types of surgical conditions associated with HIV-1 in pediatric patients.
Main Methods:
- Retrospective review of medical records of infants and children admitted with HIV-1 infection.
- Data collection spanned a 2-year period (December 1994 to December 1996).
Main Results:
- 63 HIV-1 infected children presented to the surgical unit; 17 had acquired immunodeficiency syndrome (AIDS).
- Infections were the most common presenting problem (n=37), including abscesses, cellulitis, osteitis, and perineal sepsis.
- Generalized lymphadenopathy (n=14) and non-HIV-related congenital anomalies (n=9) were also noted. Tumors, including Kaposi sarcoma, were identified.
Conclusions:
- A significant proportion of pediatric surgical patients had HIV-1 infection, with varied presentations.
- While many presented with infections or AIDS, a notable percentage were asymptomatic or had non-HIV-related issues.
- Surgical teams must maintain a high index of suspicion for HIV-1 in pediatric patients, even with seemingly unrelated conditions.
Purpose/Methods:
Review of the records of infants and children admitted with human immunodeficiency virus type 1 (HIV-1) infection was undertaken to determine the mode and pattern of presentation at the Paediatric Surgical Unit, King Edward VIII Hospital, Durban.
Results:
Over the 2-year period-December 1994 to December 1996-63 patients with recognised HIV infection presented to the surgical unit. Seventeen were known to have acquired immunodeficiency syndrome (AIDS). Infection was the most common presenting problem (n = 37). In this group, 14 had abscesses, cellulitis, or osteitis. 18 had perineal sepsis-11 had acquired rectovaginal fistulae, two had fistulae-in-ano, one a perianal abscess, two had perineal condylomata, and two had rape-related injuries and sepsis. Three children presented with overwhelming sepsis, one neonate presented with haemorrhagic colitis caused by cytomegalovirus, and one older child presented with oesophageal candidiasis. Generalised lymphadenopathy was the presenting complaint in 14 children. Biopsy results showed nonspecific reactive changes in six children, HIV-reactive changes in five, and tuberculosis in three patients. Ten children presented with non-HIV-related problems; nine were neonates with congenital anomalies. An older child presented with a coin impacted in his oesophagus. Two children presented with tumours-one had a Kaposi sarcoma and one had a Wilms' tumour.
Conclusions:
Twenty-six percent had clinical manifestation of AIDS, 19% presented with lesions diagnostic of HIV infection, 22% presented with signs or symptoms that were suggestive of the disease, and 33% were asymptomatic of HIV infection.