Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

Abstract

Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition.

Morphological changes in the digestive system of 93 human immunodeficiency virus positive patients: an autopsy study

“…Autopsy studies evaluating the digestive system of patients with AIDS do not report the finding of toxoplasmosis at this site 5,22 . The Brazilian study of Uberlândia reports 4% cases of toxoplasmosis in 52 autopsies 3 . Two of them had involvement of esophagus, stomach and intestine.…”

“…Epidemiologic differences, both regional and between different countries are showed in Latin American and African studies when compared to North American and European studies 11,24,25,26 . Several changes in the digestive system are observed only at autopsy 3,19,20 , however, there is only one study specifically evaluating the scope of gastrointestinal pathology in AIDS in Brazil 5 and another one elsewhere 22 . The aim of this study was to identify morphological changes in each segment of the digestive system associated to human immunodeficiency virus (HIV) infection and to AIDS and also to know the importance of these lesions related to death.…”

Cryptococcosis in Acquired Immunodeficiency Syndrome Patients Clinically Confirmed and/or Diagnosed at Necropsy in a Teaching Hospital in Brazil

“…6,15 Some reports have shown discrepancies between clinical and postmortem cryptococcosis diagnosis whereas others have pointed out some concerns with the decreasing rate of postmortem examination in teaching hospitals around the world. 13,[16][17][18] The aim of this study is to present clinical and epidemiological data of AIDS patients with cryptococcosis diagnosed and/ or confirmed at necropsy in a teaching hospital in Brazil.…”

Clinical forms and outcome of tuberculosis in HIV-infected patients in a tertiary hospital in São Paulo - Brazil

“…This means that there are 11 million coinfected adults and TB is the main cause of death [3][4][5]. Among the 23 countries with the highest incidences of TB in the world, Brazil holds the 14 th position [6].…”