FOOD CAPACITY EVOLUTION IN A CASE OF HIV AND NEUROTOXOPLASMOSIS WITH OROPHARYNGEAL DYSPHAGIA

Ano: 2013 | Volume: 17 | Número: Suplemento

Autores: Otto DM, Bilheri DFD, Almeida ST.

Resumo Inglês:

OBJECTIVE: To describe the evolution of a patient with a swallowing disorder resulting from HIV and neurotoxoplasmosis. CASE REPORT: C.L.P.C. was a 29-year-old woman who was born in Porto Alegre (RS), Brazil. She remained in the intensive care unit (ICU) for 45 days because of neurotoxoplasmosis, a neurological disease common in patients with human immunodeficiency virus (HIV) that affects the central nervous system and causes neurological motor deficits associated with mental confusion, seizures, hemiparesis, diplopia, apraxia, aphasia, sensory changes, and dysphagia. She received care from a speech therapist who diagnosed oropharyngeal dysphagia, which was moderate on the GUSS scale (Trapl M et al. 2007). She received oral feedings with pasty foods, had a permanent nasogastric tube, and had a tracheostomy performed. Presenting symptoms were nausea, vomiting, dysphagia, hemiparesis of the right side, and a change in the strength and sensitivity of the tongue, soft palate, and vocal mobility (e.g., reduced loudness). Speech therapy was begun in the ICU and continued until her transfer to the general ward. Therapy consisted of direct and indirect swallowing. After 15 days of treatment, she began oral feeding with bland foods-showing functional swallowing on the revaluation of speech therapy-and her vocal function improved with adequate loudness. CONCLUSION: We observe that early speech therapy in patients with neurotoxoplasmosis and HIV assists in the detection of swallowing disorders and in the rehabilitation of feeding and vocal functions.