Common diseases of HIV-positive adults (Pg. 173) - C

Question 1

CD/presentation/findings

Candida albicans (CD/presentation/findings)

Answer 1

• CD4+ cell count < 500/mm3
• Presentation: Oral thrush
• Findings: Scrapable white plaque, pseudohyphae on microscopy

Question 2

CD/presentation/findings

EBV (CD/presentation/findings)

Answer 2

• CD4+ cell count < 500/mm3
• Presentation: Oral hairy leukoplakia
• Findings: Unscrapable white plaque on lateral tongue

Question 3

CD/presentation/findings

Bartonella henselae (CD/presentation/findings)

Answer 3

• CD4+ cell count < 500/mm3
• Presentation: Bacillary angiomatosis
• Findings: Biopsy with neutrophilic inflammation

Question 4

CD/presentation/findings

HHV-8 (CD/presentation/findings)

Answer 4

• CD4+ cell count < 500/mm3
• Presentation: Kaposi sarcoma
• Findings: Biopsy with lymphocytic inflammation

Question 5

CD/presentation/findings

HPV (CD/presentation/findings)

Answer 5

• CD4+ cell count < 500/mm3
• Presentation: Squamous cell carcinoma, commonly of anus (men who have sex with men) or cervix (women)
• Findings: Koilocytes on pap smear

Question 6

CD/presentation/findings

Cryptosporidium (CD/presentation/findings)

Answer 6

• CD4+ cell count < 500/mm3
• Presentation: Chronic Watery Diarrhea
• Findings: Acid fast oocysts in stool

Question 7

CD/presentation/findings

Histoplasma capsulatum (CD/presentation/findings)

Answer 7

• CD4+ cell count < 200/mm3
• Presentation: Fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting, diarrhea
• Findings: Oval yeast cells within macrophages

Question 8

CD/presentation/findings

HIV (CD/presentation/findings)

Answer 8

• CD4+ cell count < 200/mm3

- Presentation: Dementia

Question 9

CD/presentation/findings

JC virus (reactivation) (CD/presentation/findings)

Answer 9

• CD4+ cell count < 200/mm3
• Presentation: Progressive multifocal leukoencephalopathy
• Findings: Nonenhancing areas of demyelination on MRI

Question 10

CD/presentation/findings

Pneumocystis jirovecii (CD/presentation/findings)

Answer 10

• CD4+ cell count < 200/mm3
• Presentation: Pneumocystis pneumonia
• Findings: “Ground-glass” opacities on CXR

Question 11

CD/presentation/findings

Aspergillus fumigatus (CD/presentation/findings)

Answer 11

• CD4+ cell count < 100/mm3
• Presentation: Hemoptysis, pleuritic pain
• Findings: Cavitation or infiltrates on chest imaging

Question 12

CD/presentation/findings

Candida albicans (CD/presentation/findings)

Answer 12

• CD4+ cell count < 100/mm3
• Presentation: Esophagitis
• Findings: White plaques on endoscopy; yeast and pseudohyphae on biopsy

Question 13

CD/presentation/findings

CMV (CD/presentation/findings)

Answer 13

• CD4+ cell count < 100/mm3
• Presentation: Retinitis, esophagitis, colitis, pneumonitis, encephalitis
• Findings: Linear ulcers on endoscopy, cotton-wool spots on fundoscopy

Biopsy reveals cells with intranuclear (owl eye) inclusion bodies

Question 14

CD/presentation/findings

Cryptococcus neoformans (CD/presentation/findings)

Answer 14

• CD4+ cell count < 100/mm3
• Presentation: Meningitis
• Findings: Encapsulated yeast on India ink stain or capsular antigen ⊕

Question 15

CD/presentation/findings

Cryptosporidium spp. (CD/presentation/findings)

Answer 15

• CD4+ cell count < 100/mm3
• Chronic, watery diarrhea
• Acid-fast oocysts in stool

Question 16

CD/presentation/findings

EBV (CD/presentation/findings)

Answer 16

• CD4+ cell count < 100/mm3
• B-cell lymphoma (eg, non-Hodgkin lymphoma, CNS lymphoma)
• CNS lymphoma—ring enhancing, may be
  solitary (vs Toxoplasma)

Question 17

CD/presentation/findings

Mycobacterium avium–intracellulare, Mycobacterium avium complex (CD/presentation/findings)

Answer 17

• CD4+ cell count < 100/mm3

- Nonspecific systemic symptoms (fever, night sweats, weight loss) or focal lymphadenitis

Question 18

CD/presentation/findings

Toxoplasma gondii (CD/presentation/findings)

Answer 18

• CD4+ cell count < 100/mm3
• Brain abscesses
• Multiple ring-enhancing lesions on MRI