OpportunisticInfectionsKA - Opportunistic Infection...

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Opportunistic Infection Presentation CD4 Count Diagnostics Treatment/ (prophylactic) Other Pneumonia (oltion) *Progressive exertional dyspnea (95%) *Fever (>80%) *Nonproductive cough (95%) *Chest discomfort *Weight loss *Chills *Hemoptysis (rare ) <200 *Lactic dehydrogense(LDH)- usually elevated >220 U/L *CXR- Diffuse bilateral infiltrates extending from the perihilar region. *Sputum sample by sputum induction for histopathologic testing. *BAL- Bronchoalveolar lavage *Trimethoprim- sulfamethoxazo le (TMP-SMX) for 21 days. *Corticosteroid in severe PCP as defined by a room air arterial oxygen pressure of < 70 mm Hg or an arterial- alveolar O2 gradient >35 mm Hg. Prevention of PCP. *Patients with CD4 count of less than 200/µL, oropharyngeal candidiasis, unexplained fever >100°F (37.7° C) for more than 2 weeks, and a prior episode of PCP regardless of CD4 count should receive prophylaxis. *D/C the prophylaxis if CD4>200 for 3 consecutive months. *Restart if CD4<200. *if patient had PCP when CD4>200. prophylaxis should be continued for life. Karposi’s Sarcoma Cutaneous lesions: usually *Can occur *CD4 count and viral *First step: highly *Most common
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(Nicole) multicentric in continuum of development GI lesions: usually asymptomatic and indicates advanced HIV infection; symptoms include dysphagia, nausea, vomiting and hematemesis Pulmonary involvement: cough, dyspnea, hemoptosis and chest pain (difficult to distinguish from opportunistic infection); pleural effusions are exudative and bloody Lymphadenopathy * of patients develop a second malignancy, commonly non-Hodgkins lymphoma *The brain is spared
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