Tirif

Question 1

Opportunistic infections in HIV for which prophylaxis is given

Answer 1

PCP,(CD4 <200), toxo <100- cotri
Histoplasma capsulatum<100- itraconazole
VZV- vaccine or IVIG post exposure

Question 2

A pt with tic bite 2wks ago in Arkansas came with fever headache malaise myalgia an slight confusion. He has no rash
Lab- thrombocytopenia, leukopenia, elivated transaminases
Dx?
Next step in the mx?

Answer 2

Ehrlichiosis ( Rocky Mountain spotted fever without the spots)
Doxycycline- empiric- Dx is often made clinically but definitive dx can b made by looking at intracytoplasmic morulae in WBCs

Question 3

Place of steroids in the Rx of PCP

Answer 3

Given in severe PCP because hypoxia worsens with initiation of Rx ( release of pro inflammatory molecules during lysis of the organism)
Indications- PaO2<=70, A-a gradient >35, pulse oxymetry <92% on room air