J Korean Soc Emerg Med.  2003 Aug;14(3):258-263.

Analysis of Undiagnosed HIV- Positive Patients in the Emergency Room

• Seo DW
• Lim KS
• Lee JH
• Youn JC
• Kim W

Abstract

PURPOSE
The purpose of this article is to analysis undiagnosed HIV-positive patients in the Emergency Room (ER). We expect these analysis to be of help in preventing exposure to HIV and in making a diagnosis effectively.
METHODS
A retrospective analysis by chart review was carried out on 8 unrecognized HIV patients who had been admitted to the ward via the ER from December 2000 to August 2002.
RESULTS
The results were as follows: 1) The chief complaints were fever with mental change, dyspnea, hemiparesis, dyspnea with fever, chronic diarrhea with fever, abdominal discomfort, and dyspnea with fever and vertigo. 2) The 8 patients all had AIDS as well as other diseases. 3) The reasons for the anti-HIV test were continuous fever of unknown origin (FUO) 33.3%, chest X-ray abnormality 20.0%, VDRL (Venereal Disease Research Laboratory) test positive 13.3%, pre-operation screening blood test 13.3%. The rest were due to MRI (magnetic resonance image) abnormality, intraabdominal tuberculosis, and Cryptococcus in cerebrospinal fluid and comprised 6.7% of the total.
CONCLUSION
We recommend that an anti-HIV test be given in the ER for patients who have FUO, infiltration of both lungs in the chest X-ray and a VDRL positive in serum. We also recommend that an anti-HIV test be given in the ER for patients with suspected HIV-related encephalopathy, tuberculosis, Pneumocystis carinii pneumonia, recurrent pneumonia, and progressive multi-focal leukoencephalopathy.

Keyword

HIV; AIDS; Emergency room; Indicators; Conditions

MeSH Terms

Cerebrospinal Fluid
Cryptococcus
Diagnosis
Diarrhea
Dyspnea
Emergencies*
Emergency Service, Hospital*
Fever
Fever of Unknown Origin
Hematologic Tests
HIV
Humans
Leukoencephalopathies
Lung
Magnetic Resonance Imaging
Mass Screening
Paresis
Pneumonia
Pneumonia, Pneumocystis
Retrospective Studies
Thorax
Tuberculosis
Vertigo