Specialist ENT AIDS IN ENT

AIDS IN ENT

Acquired immunodeficiency syndrome (AIDS) is caused by the retrovirus called Human Immunodeficiency virus (HIV). The virus causes severe immunodeficiency by attacking the CD4 lymphocytes. Common routes of transmission: 1) Unprotected sexual contact. 2) Use of infected needles, razors. 3) Blood transfusion by infected blood. 4) Perinatal infection. Diagnosis:  Diagnosis made by the ELISA test and confirmation made by Western blot analysis. Incidence in ENT: Up to 80% of HIV-infected patients eventually develop ENT manifestations. Among ENT manifestations, oral disease seems to be the most common, occurring in approximately 40–50% of HIV positive patients. Clinical manifestation: 1) Oropharyngeal manifestations:

    a) Oral ulcerations: Due to viruses such as herpes simplex and cytomegalovirus.

    b) Oral candidiasis.

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c) Oral hairy leukoplakia.

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2) Neoplastic: Mucosal Kaposi’s sarcoma.

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3) Laryngeal Manifestations:

a) Hoarseness of voice.

b) Dysphagia.

c) Tuberculous infection of the larynx.

d) Laryngeal histoplasmosis.

e) Laryngeal candidiasis.

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4) Nasal and sinus manifestations:

Patients with HIV often present with nasal obstruction or irritation. Other manifestations include.

a) Nasopharyngeal lymphoid hypertrophy in early stages of HIV.

b) Neoplastic tumors of the sinuses, like mucosal Kaposi’s sarcoma and non- Hodgkin’s lymphoma.

c) Recurrent acute and chronic sinusitis.

d) Allergic fungal sinusitis.

5) Otologic manifestations:

a) Otitis externa.

b) Ear polyps.

c) Kaposi’s sarcoma of external ear.

d) Otitis media.

e) Sensorineural hearing loss.

f) Ramsay Hunt syndrome.

g) Isolated facial nerve paralysis.

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6) Head and neck manifestations:
a) Lymphadenopathy is the most common finding in HIV infected patients.
b) Recurrent parotid enlargement.
c) Neck abscess.
d) Neoplastic masses such as lymphomas.
Treatment:
1) Anti – HIV drugs.
2) Antibiotics.
3) Antifungals.
4) Symptomatic treatment.

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