FA Micro 6 Common Diseases of HIV-positive adults
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Created by:
zingspeed27 on March 23, 2012
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19 terms
Chemistry | Math / Symbols |
|---|---|
 As CD4 count ↓, what increases? | As CD4 count ↓, risk of reactivation of past infections (e.g. TB, HSV, shingles), dissemination of bacterial infections and fungal infections (e.g. coccidioidomycosis), and non-Hodgkin's lymphomas ↑. |
| Systemic Clinical presentation: 1. Low-grade fevers 2. Cough 3. Hepatosplenomegaly 4. Tongue ulcer Findings/labs, pathogen | Findings/labs: 1. Oval yeast cells within macrophages 2. CD4 < 100 Pathogen: Histoplasma capsulatum (causes only pulmonary symptoms in immunocompetent hosts) |
| Dermatologic Clinical presentation: Fluffy white cottage-cheese lesions Findings/labs, pathogen | Findings/labs: Pseudohyphae, commonly 1. Oral if CD4 < 400 2. Esophageal if CD4 < 100 Pathogen: C. albicans (causes thrush) |
| Dermatologic Clinical presentation: Superficial vascular proliferation Findings/labs, pathogen | Findings/labs: Biopsy reveals neutrophilic inflammation Pathogen: Bartonella henselae (causes bacillary angiomatosis) |
| Gastrointestinal Clinical presentation: Chronic, watery diarrhea Findings/labs, pathogen | Findings/labs: Acid-fast cysts seen in stool especially when CD4 < 200 Pathogen: Cryptosporidium spp. |
| Neurologic Clinical presentation: Encephalopathy Findings/labs, pathogen | Findings/labs: 1. Due to reactivation of a latent virus 2. Results in demyelination 3. CD4 < 200 Pathogen: JC virus reactivation (cause of PML) |
| Neurologic Clinical presentation: Abscesses Findings/labs, pathogen | Findings/labs: 1. Many ring-enhancing lesions on imaging 2. CD4 < 100 Pathogen: Toxoplasma gondii |
| Neurologic Clinical presentation: Meningitis Findings/labs, pathogen | Findings/labs: 1. India ink stain reveals yeast with narrow-based budding and large capsule 2. CD4 < 50 Pathogen: Cryptococcus neoformans (may also cause encephalitis) |
| Neurologic Clinical presentation: Retinitis Findings/labs, pathogen | Findings/labs: 1. Cotton-wool spots on funduscopic exam and may also occur with esophagitis 2. CD4 < 50 Pathogen: CMV |
| Neurologic Clinical presentation: Dementia Findings/labs, pathogen | Findings/labs: Must differentiate from other causes Pathogen: Directly associated with HIV |
| Oncologic Clinical presentation: Superficial neoplastic proliferation of vasculature Findings/labs, pathogen | Findings/labs: Biopsy reveals lymphocytic inflammation Pathogen: HHV-8 (causes Kaposi's sarcoma), do not confuse with B. henselae |
| Oncologic Clinical presentation: Hairy leukoplakia Findings/labs, pathogen | Findings/labs: Often on lateral tongue Pathogen: EBV |
| Oncologic Clinical presentation: Non-Hodgkin's lymphoma (large cell type) Findings/labs, pathogen | Findings/labs: Often on oropharynx (Waldeyer's ring) Pathogen: May be associated with EBV |
| Oncologic Clinical presentation: Squamous cell carcinoma Findings/labs, pathogen | Findings/labs: Often in anus (MSM) or cervix (females) Pathogen: HPV |
| Oncologic Clinical presentation: Primary CNS lymphoma Findings/labs, pathogen | Findings/labs: Focal or multiple, differentiate from toxoplasmosis Pathogen: Often associated with EBV |
| Respiratory Clinical presentation: Interstitial pneumonia Findings/labs, pathogen | Findings/labs: Biopsy reveals cells with intranuclear (owl's eye) inclusion bodies Pathogen: CMV |
| Respiratory Clinical presentation: Invasive aspergillosis Findings/labs, pathogen | Findings/labs: 1. Pleuritic pain 2. Hemoptysis 3. Infiltrates on imaging Pathogen: Aspergillus fumigatus |
| Respiratory Clinical presentation: Pneumonia Findings/labs, pathogen | Findings/labs: Especially with CF4 < 200 Pathogen: Pneumocystis jiroveci |
| Respiratory Clinical presentation: Tuberculosis-like disease Findings/labs, pathogen | Findings/labs: Especially with CD4 < 50 Pathogen: Mycobacterium avium-intracellulare |
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