Opportunistic Infections w/ AIDS Flashcards
When is a person who was infected with HIV at highest risk of OIs?
when their CD4 count drops below 200.
What are the sx of the most common OI infection associated with aids?
-PCP (Pneumocystis Carinii Pneumonia)
Sx: fever, cough, SOB, hypoxia (PO2
PCP Diagnostic Tests
- CXR***
- Wright Giemsa Stain or direct fluorescence aby test on sputum
- Bronchoalveolar lavage (get sputum from bronchi via irrigation)
- Elevated Lactate Dehydrogenase
When is a HIV patient at risk for development of PCP?
- Treatment
- Complications
-CD4 250.
OR
Prophylaxis: Never had PCP but CD4 200.
-Pneumothorax
Mycobacterium Avian Complex
- Types
- Dx
- Sx and Symptoms
- Risk
- Tx
Types: Pulmonary or Disseminated, Meningeal involvement in disseminated.
Dx: blood cultures positive if disseminated.
Sx:
- spiking fevers
- night sweats
- Diarrhea
- Weight loss
- Wasting
- anemia & Neutropenia
- meningeal signs
Risk:
-CD4100 cells.
Kaposi’s Sarcoma
- what is this?
- what does it look like?
- where may it occur?
- lesions may appear anywhere.
- purple, nonblanching**, may be papular or nodular, appear brown in dark skin, nonpainful
–most often face and legs, but may be on palate, eyelids, conjunctiva, pinnae, toe webs
Can you get Kaposis Sarcoma deeper than your skin?
-yes, may be intestinal, lymph, lungs.
sx:
Intestine:
–abd pain, diarrhea, intestinal obstruction
Lymph::
–swelling of arms and legs
Lungs:
-cough, chest pain, SOB, dyspnea, swelling, pulmonary blockage.
Tx of Kaposi Sarcoma
-contained skin lesions may not require tx
- lesions that involve large areas of the skin or internal organs tx:
- -topical medication
- -surgical removal
- -freezing w/ liquid nitrogen
- -chemo drugs
- -liposomal drugs (like chemo drug but they are encased in fat so they have less SE)
Cryptococcus Neoformans
- Signs and Sx
- Dx
- Tx
- Risk
Sx: meningitis/subtle sx
-fever, HA, malaise
Dx: latex agglutination serum/CSF testing for Ag (CRAG)
Tx:
- Amphotericin B
- Prophylaxis: fluconazole (Diflucan)
*Most common life-threatening fungal infection in AIDS.
Risk:
Cryptosporidiosis AKA What is this? Where does it live? What benefits does its protective shell have?
AKA Crypto
Crypto is a diarrheal disease caused by the microscopic parasite Cryptosporidium
It can live in human and animal intestines and be passed in the stool in every region of the world
The protective shell allows it to survive outside the body for extended periods and makes it very resistant to chlorine-based disinfectatnts
**One of the most common causes of waterborne disease in humans in the US
Crypto
- Most common sx
- other sx
- most common rgan infected
- how does this affect a non-immunocompromised pt?
- How does this affect HIV pts with CD4 200?
- Most common sx: watery diarrhea
- other sx: stomach cramps, dehydration, nausea, vomiting, fever, and weight loss, some are asymptomatic
- most common organ infected: small intestine
- non-immunocompromised: sx last 1-2 weeks
- How does this affect HIV pts with CD4 200? may last for 2-4 weeks, however may remain in carrier state and give to others or infect self if CD4 count drops below 200
Crypto
- How is it spread?
- dx
- tx
spread via the fecal oral route- swimming or bathing in contaminated water, drinking contaminated water
dx- stool specimens for cryptosporidium (ask specifically for the test, it is not routine)
tx- There is no approved tx for HIV+ pts!!! If CD4 count can be improved they may have remission, but no cure.
Cytomegalovirus retinitis (CMV)
- signs
- sx
- risk
- tx
signs- perivascular hemorrhages, white fluffy exudates
sx- usually painless loss of vision, often unilateral, blurred vision, floaters
risk- when CD4 levels
GI manifestations of AIDS
- Candidal Esophogitis
- -very common in HIV pt
- Hepatic Disease
- -neoplasms, co-infection w/ Hep B & C
- Biliary Disease
- -acalculous cholecystitis
Is Esophageal Candidiasis an AIDS defining illness? What are the sx? when are you at risk? Tx?
- yes, oral candidiasis is not.
- occurs with CD4