Abstract:
Babies and children infected by HIV virus may have symptoms evocative of pain. The causes are diverse, including etiologies other than the classical ones such Candida esophagitis causing pain during deglutition or infectious diarrhea provoking abdominal pain for which cause and reliability of the pain are recognized and lead to the prescription of an antalgic. We observed different clinical presentations with special peculiarities always associated with neurological involvement which is specific of HIV infection. The appearance of neurological syndrome always shows the severity of the evolution, although the clinical expression may be variable in intensity and in severity. It is associated, generally, with a regression in the psychomotor development and of behavioral accomplishment. The different clinical observations are (1) behavioral disorders such as crying crisis, or sudden crying without any apparent causes and which can possibly be calmed by taking the child in the arms. This can be due to sudden muscular contractions caused by pyramidal hypertonia and for neurovegetative involvement. (2) For some children, the neurological degradation leads to a catatonic, set, appearance and attitude. The children are often very silent and seem to fear anyone's approaching. (3) In HIV infection, severe gut infections that are not controlled may lead to cachexia. The child is retired within itself and seems in pain. This is observed, generally, in terminal phase. In those 3 situations, the reality of the pain is difficult to estimate. The doctors are questioning themselves on the necessity of prescribing, provoking conflicts with nurses convinced of the reality of pain. Clinical illustrations are given and a videotape is presented.
Keywords: Child Human HIV Infections/*PHYSIOPATHOLOGY Opportunistic Infections/PHYSIOPATHOLOGY Pain/*ETIOLOGY/THERAPY Palliative Care JOURNAL ARTICLE 901230
M90C3716
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