HIV opportunistic infections

Question 1

MAI/MAC
CD4 < _____
presentation and findings

Answer 1

CD4 < 100

-nonspecific systemic sxs (fever, night sweats, weight loss) or focal lymphadenitis

Question 2

toxoplasma gondii
CD4 < _____
presentation and findings

Answer 2

CD4 < 200

-brain abscesses; multiple ring enhancing lesions on MRI

Question 3

candida albicans
CD4 < _____
presentation and findings

Answer 3

CD4 < 500
-oral thrush; scrapable white plaque with pseudohyphae

CD4 < 100
-esophagitis; white plaques on endoscopy; yeast and pseudohyphae on bx

Question 4

histoplasma
CD4 < _____
presentation and findings

Answer 4

CD4 < 100

• fever, weight loss, fatigue, cough, dyspnea, N/V/D
• oval yeast cells within macrophages

Question 5

EBV
CD4 < _____
presentation and findings

Answer 5

CD4 < 100

• B cell lymphoma like non-Hodgkin lymphoma and CNS lymphoma
• CNS lymphoma = solitary ring enhancing lesion vs. toxo, which is multiple ring enhancing lesions

CD4 < 500
-oral hairy leukplakia; unscrapable white plaque on lateral tongue

Question 6

CMV
CD4 < _____
presentation and findings

Answer 6

CD4 < 100

• retinitis, esophagitis, colitis, pneumonitis, encephalitis
• linear ulcers on endoscopy
• cotton wool spots on fundoscopy
• bx reveals cells with intranuclear owl eye inclusion bodies

Question 7

cryptococcus neoformans
CD4 < _____
presentation and findings

Answer 7

CD4 < 100

• meningitis
• thickly encapsulated yeast on India ink stain

Question 8

aspergillus fumigatus
CD4 < _____
presentation and findings

Answer 8

CD4 < 100

• hemoptysis, pleuritic pain
• cavitation or infiltrates on chest imaging

Question 9

PCP
CD4 < _____
presentation and findings

Answer 9

CD4 < 200

• PCP pneumonia
• ground glass opacities on CXR

Question 10

JC virus (reactivation)
CD4 < _____
presentation and findings

Answer 10

CD4 < 200

• PML
• nonenhancing area of demyelination on MRI

Question 11

HIV dementia

CD4 < _____

Answer 11

CD4 < 200

Question 12

HPV
CD4 < _____
presentation and findings

Answer 12

CD4 < 500

-SCC of anus or cervix

Question 13

cryptosporidium spp
CD4 < _____
presentation and findings

Answer 13

CD4 < 500

• chronic watery diarrhea
• acid fast oocysts in stool

Question 14

HHV8
CD4 < _____
presentation and findings

Answer 14

CD4 < 500

• kaposi sarcoma
• bx with lymphocytic inflammation

Question 15

bartonella henselae
CD4 < _____
presentation and findings

Answer 15

CD4 < 500

• bacillary angiomatosis
• bx with neutrophilic inflammation