Clinical presentations of HIV Flashcards
What other illness should you think about in a patient when you suspect has glandular fever?
HIV
Which other STI often co-exists with HIV?
syphilis
What are symptoms of primary HIV/Seroconversion?
Soar throat Fever Lymphadenopathy Malaise/lethargey Arthralgia/myalgia Rash - maculopapular rash on trunk Orogenital/perianal ulceration Headache/meningism Diarrhoea
How long after infection does seroconversion generally take place? What proportion of patients have symptoms?
2-6 weeks
Symptoms in 60%
Why should people with TB be screened for HIV?
often co-exist
When would you consider HIV in a patient with shingles?
Young otherwise fit patient
Severe
Multidermatomal
Other clinical clues of immunosuppression
HIV risk factors
How are psoriasis and HIV linked?
HIV may trigger or exacerbate psoriasis
What malignancies are related to AIDS?
Kaposis sarcoma
Non-Hodgkins lymphoma
Invasive cervical carcinoma
What should all people with non-hodgkins lymphoma be screened for?
HIV
What does molluscum contagiosum on the face indicate?
Immunosuppression
What are some non-AIDS defining malignancies?
Hodgkin's lymphoma Anal cancer Hepatocellular carcinoma Head and neck/oral cancer Lung cancer (non-small cell and adenocarcinoma)
What are some risk factors for non-AIDS-defining malignancies?
Increasing age Low CD4 Lack of HIV treatment Smoking HBV infection Oncogenic HPV-type infection
When, in a history should you consider HIV as a differential diagnosis?
If presentation of something is:
atypical
recurrent
severe
RISK OF HIV INFECTIOn
List some general clinical syndromes where HIV could be a differential diagnosis?
Lymphadenopathy Weight loss Night sweats / PUO Confusion / dementia “Glandular fever”
List some oral conditions where HIV could be a differential diagnosis?
Candida Oral hairy leukoplakia KS Gingivitis Aphthous ulceration
List some dermatological conditions, where HIV could be a differential?
Psoriasis (newly presenting or worsening)
Acne
Impetigo
Itchy folliculitis
Seborrhoeic dermatitis
Fungal infections– tinea pedis/cruris, pityriasis versicolor, onychomycosis
HSV– frequently recurring, disseminated, severe
HZV – recurrent chicken pox, shingles in young patient, multidermatomal shingles
Crusted scabies
Molluscum contagiosum- giant, facial
Viral warts – severe, recalcitrant, oral
What are some respiratory conditions where HIV could be a differential diagnosis?
Atypical pneumonia
Recurrent bacterial pneumonia
TB
What are some gastro conditions where HIV could be a differential diagnosis?
Oesophageal candida
Chronic diarrhoea
What are some haematological conditions where HIV could be a differential diagnosis?
Thrombocytopenia
Lymphopneia
Lymphoma
How might pneumocystis pneumonia show up on an X-ray?
Pulmonary interstitial infiltrates
Pneumatoceles
(ground glass appearance)
Predominant hilar
What are some symptoms of pneumocystis pneumonia?
fever (low grade)
dry cough
SOB
Often presents sub-acutely
