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

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Aércio Sebastião BORGES, Marcelo Simão FERREIRA, Sérgio de Andrade NISHIOKA, Marco Túlio Alvarenga SILVESTRE, Arnaldo Moreira SILVA, Ademir ROCHA
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1997
• Subjects: AIDS; Necropsy; Opportunistic infections; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Sida
• Online Access: https://doi.org/10.1590/S0036-46651997000400007; https://doaj.org/article/53b9e80ccecf42fd8fe154e0ee9e8378

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 Concordância entre diagnósticos clínicos e de necrópsia em pacientes com síndrome da imunodeficiência adquirida observados em um hospital universitário brasileiro A síndrome da imunodeficiência adquirida (SIDA) é uma das principais causas de morte em adultos em todo mundo. Com maior freqüência do que ocorre na população geral, há em pacientes com SIDA uma substancial discordância entre as causas de morte clinicamente suspeitadas e as estabelecidas pelas autópsias. Revisamos os achados de 52 necrópsias de pacientes com SIDA e seus respectivos diagnósticos clínicos, e encontramos 46% de concordância entre eles. Cinquenta e dois por cento dos pacientes tiveram mais de um diagnóstico necroscopicamente definido e 48% tiveram pelo menos uma doença relacionada à SIDA, não suspeitada clinicamente. Infecção pelo citomegalovírus foi o ...