infectious diseases Flashcards
(15 cards)
What are the clinical features of HIV seroconversion illness?
- fever
- lymphadenopathy
- maculopapular rash
- atrhalgia/myalgia
- pharyngitis
- nausea/vomitting/diarrhoea
- aseptic meningitis
resembles infectious mononucleosis
50% suffer from it, 3-6 weeks after acquisition of virus, no implication for prognosis
What are respiratory complications of HIV?
PJP or other fungal pneumonia
lymphoid interstitial pneumonitis
bacterial pneumonia
What are GI complications of HIV?
crytosporidiosis/microsporidiosis - diarrhoea, weight loss
CMV colitis - diarrhoea, abdominal pain
oesophageal candidiasis - ondynophagia
biliary disease - vomitting/nausea
drug side effects - pancreatitis, diarrhoea
What are neurological complications of HIV?
cryptococcal meningitis toxoplasmosis NHL PML dementia neuropathy CMV radiculopathy
What are renal complications of HIV?
nephrotic syndrome
sepsis –> renal failure
drug side effects
What are dermatological complications of HIV?
drug rashes shingles fungal skin rashes kaposi's sarcoma psoriasis scabies seborrhoeic dermatitis
What are oral and ocular complications of HIV?
CMV retinitis aphthous and viral ulcers gingivitis hairy leukoplakia candidiasis
What are haematological complications of HIV?
anaemia - suppression or infiltration
drug related anaemia
uncommon - thrombocytopenia and neutropenia
What tests should be ordered for a new diagnosis of HIV prior to starting ART?
HIV viral load and genotype CD4 cell count hepatitis B and C serology EUC/LFTs lipid profile tuberculin skin test CXR syphilis serology based on risk screen for HLAB5701 if starting abacavir pregnancy if female CMV antibody status if CD4 count < 200 - crytptococcal antigen, stool OCP
What OI’s occur at a CD4 count < 100?
cryptococcal meningitis toxoplasmosis CNS lymphoma HIV dementia PML - JC virus disseminated MAC disseminated CMV
What OI’s occur at a CD4 count < 200?
PJP oesophageal candidiasis microsporidium/cryptosporidium diarrhoea peripheral neuropathy military or extra pulmonary TB herpes simplex muscle wasting
What OI’s occur at a CD4 count 200-500?
shingles oral candidiasis hairy leukoplakia (EBV) kaposi's sarcoma (HHV8) pulmonary TB lymphoid interstitial pneumonitis ITP
What primary prophylaxis is needed for a CD4 count < 200?
pneumococcal vaccination bactrim DS 1 tablet daily - for PJP and toxoplasmosis cease if CD4 > 200 for 3 months inhaled pentamidine if sulphur allergy
What primary prophylaxis is needed for a CD4 count < 50?
pneumococcal vaccine + bactrim DS 1 tablet daily +
azithromycin 1g weekly - for MAC
cease if CD4 > 100 for 3 months and/or completed 12 months of treatment for MAC
What are long term management issues for patients with HIV?
smoking cessation lipid management weight and exercise malignancy surveillance - liver if hep, skin, colon compliance vaccinations sexual health screening finances
