42 terms

SDL- opportunistic infections

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interstitial pneumonia
PCP produces this type of pneumonia, often with a ground glass apperance on xray and CT
TMX-SMX and IV or inhaled pentamidine
treatment for PCP
21 days
duration of TMX-SMX and IV or inhaled pentamidine for HIV patients with PCP infection
14 days
duration of TMX-SMX and IV or inhaled pentamidine for regular patients with PCP infection
corticosteroids
in addition to antibiotic therapy, these drugs are added to treat PCP in individuals with severe respiratory compromise
TMP-SMX
agent of choice for PCP prophylaxis
dapsone, dapsone plus pyrimethamine, atovaquone, and aersolized pentamidine
drugs of choice for patients with PCP who cannot tolerate TMP-SMX
mycobacterium avium-intracellulare (MAC)
a common organism in the soil in the SE United States. up to 40% of US patients with advanced AIDS have this infection
late; early
MAC develops ........... in HIV infection while TB develops............... in HIV infection
Lady Windermere Syndrome
RML or lingular infiltrates, noted in elderly women without predisposing lung disease, volume loss, adenopathy or cavitation
avoidance and glucocorticoids
treatment for hypersensitivity pneumonitis ("hot tub lung"), often secondary to MAC infection
clarithromycin (or azithromycin) and ethambutol for 18-24 months
treatment for MAC infection
rifampin or floroquinolone
some recommend adding these drugs in patients with MAC infection who have secondary or more advanced disease
rifampin, clarithromycin or azithromycin, ethambutol, streptomycin (for 2 months)
the 4 drug therapy for resistant or failed MAC treatment.
18-24 months
duration of treatment for resistant or failed MAC treatment
12 months
treat for this duration after sputum is negative for MAC
INH, rifampin, ethambutol
treatment for M. Kansasii
clarithromycin or azithromycin
treatment for M. Kansasii (second most cause of NTM) if resistant to rifampin
heterophile antibody negative
in CMV mononucleosis, this is negative instead of positive (like EBV mono)
CMV
include this disease in differential with granulomatous hepatitis
false
T/F: antiviral therapy is indicated for CMV
marrow transplant
this procedure is associated with CMV pneumonia in 15-20% with a case fatality of >80%
Candida
the #1 nosocomial infection among compromised and noncompromised patients
fluconazole, itraconazole, voriconazole, or amphotericin B
treatment for candida
cryptococcus
the only fungus that exists only a yeast and is not dimorphic (unlike other fungi that have a yeast and mold form)
amphotericin B, flucytosine,
induction treatment for cryptococcosis
indefinetely
fluconazole is given ......... in patients with HIV cryptococcosis unless CD4+ count due to HAART rises to >100 for > 6 months
Histoplasma capsulatum
most prevalent endemic mycosis in N. America. infection by inhalation of wind blown earth in which the fungus leaves.
yeast with macrophage
no treatment
treatment for histoplasmosis in immune competent patients
amphotericin B for 7-14 days
initial treatment for histoplasmosis (acute illness)
itraconazole, voriconazole, or fluconazole
consolidation treatment for histoplasmosis
amphotericin B
treatment for coccidiomycosis if widely disseminated and acutely ill
voriconazole
normal treatment of choice for coccidiomycosis
histoplasma and coccidioides
these two organisms mimic TB clinically and radiologically but not epidemiologically
histoplasma and coccidoides
these two organsims mimic each other and MAC epidemiologically
Blastomyces
all who are infected by this organism need treatment. it is a dimorphic fungus that is endemic to midwestern and south central US. caused by inhalation of the orgnaism in the lung
voriconazole or amphotericin B and itraconazole
treatment for aspergillus pneumonia
amphotericin B
treatment for mucormycosis- mucor, rhizopus, rhizomucor (think patients with uncontrolled DM and ketoacidosis)
secondary MAC
-occurs in middle-aged/elderly men
-30-70
-smokers and alcoholics
-resembles TB
fluconazole or voriconazole
consolidation treatment for cryptococcosis
false
T/F: antibody is protective for coccidiomycosis
chronic maintenance thearpy; intraconazole
preferred treatment for blastomycosis in order to prevent re-infection