HIV AIDS opportunistic infections: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Microsporidiosis | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Microsporidiosis | ||
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*The microsporidia reported as pathogens in humans include ''Encephalitozoon cuniculi, Encephalitozoon hellem, Encephalitozoon intestinalis, Enterocytozoon bieneusi, Trachipleistophora hominis, Trachipleistophora anthropophthera, Pleistophora species, P. ronneafiei, Vittaforma corneae, Microsporidium sp, Nosema ocularum, Anncaliia connori, Anncaliia vesicularum, and Anncaliia algerae''. | |||
*The greatest risk of disease occurs among patients with a CD4+ <100 cells/µL | |||
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Clinical syndromes can vary by infecting species. The most common manifestation is diarrhea. <small> | |||
*E. bieneusi is associated with malabsorption, diarrhea, and cholangitis. | |||
*E. cuniculi is associated with hepatitis, encephalitis, and disseminated disease. | |||
*E. intestinalis is associated with diarrhea, disseminated infection, and superficial keratoconjunctivitis. | |||
*E. hellem is associated with superficial keratoconjunctivitis, sinusitis, respiratory disease, prostatic abscesses, and disseminated infection. | |||
*Anncaliia and Trachipleistophora are associated with keratoconjunctivitis. | |||
*Nosema, Vittaforma, and Microsporidium are associated with stromal keratitis following trauma in immunocompetent hosts. | |||
*Pleistophora, Anncaliia, and Trachipleistophora are associated with myositis. | |||
*Trachipleistophora is associated with encephalitis and disseminated disease.</small> | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Examination of 3 stool samples with chromotrope and chemofluorescent stains | |||
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*Patients who have CD4 counts <200 cells/µL should avoid untreated water sources. | |||
*No specific chemoprophylactic regimens are known to be effective in preventing microsporidiosis. | |||
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*Initiate or optimize ART with immune restoration to CD4 count >100 cells/mm3 | |||
*Severe dehydration, malnutrition, and wasting should be managed by fluid support and nutritional supplements | |||
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| style="padding: 5px 5px; background: #F5F5F5;" colspan=5| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents <ref name="Guidelines"> {{cite web| title=Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the | | style="padding: 5px 5px; background: #F5F5F5;" colspan=5| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents <ref name="Guidelines"> {{cite web| title=Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the |
Revision as of 16:37, 16 October 2014
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HIV AIDS opportunistic infections On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Before the widespread use of potent combination antiretroviral therapy (ART), opportunistic infections (OIs), which have been defined as infections that are more frequent or more severe because of immunosuppression in HIV-infected persons, were the principal cause of morbidity and mortality in this population. In the early 1990s, the use of chemoprophylaxis, immunization, and better strategies for managing acute OIs contributed to improved quality of life and improved survival.[1] However, the widespread use of ART starting in the mid-1990s has had the most profound influence on reducing OI-related mortality in HIV-infected persons in those countries in which these therapies are accessible and affordable.
HIV Opportunistic Infections
Bacteria
Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
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Mycobacterium tuberculosis | |||||
Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents[2] |
Virus
Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
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Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] |
Fungus
Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
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Pneumocystis Pneumonia (Click here for more information) |
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Subacute onset of progressive dyspnea, fever, nonproductive cough, and chest discomfort that worsens within days to weeks. Tachypnea, tachycardia, and diffuse dry rales are found in the physical examination. | Clinical presentation, blood tests, or chest x-rays are not pathognomonic for PCP. BAL or induced sputum samples are required for a definite diagnosis. |
Start TMP-SMX prophylaxis when CD4+ <200 cells/µL or history of oropharyngeal candidiasis. Discontinue prophylaxis when CD4+ is >200 cells/µL for >3 month. |
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Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] |
Parasite
Disease | Description | Clinical Findings | Diagnosis | Prevention / Prophylaxis | Treatment |
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Toxoplasma gondii Encephalitis (Click here for more information) |
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Focal encephalitis with headache, confusion, or motor weakness and fever |
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Administer:
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Cryptosporidiosis (Click here for more information) |
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Acute or subacute onset of watery diarrhea, nausea, vomiting, lower abdominal pain. Fever is seen in 1/3 of patients. | Microscopic examination of oocysts in stool with direct immunofluorescence. |
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Microsporidiosis |
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Clinical syndromes can vary by infecting species. The most common manifestation is diarrhea.
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Examination of 3 stool samples with chromotrope and chemofluorescent stains |
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Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] |
References
- ↑ Walensky RP, Paltiel AD, Losina E, Mercincavage LM, Schackman BR, Sax PE, Weinstein MC, Freedberg KA (2006). "The survival benefits of AIDS treatment in the United States". J. Infect. Dis. 194 (1): 11–9. doi:10.1086/505147. PMID 16741877. Retrieved 2012-04-05. Unknown parameter
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ignored (help) - ↑ 2.0 2.1 2.2 2.3 "Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Accessed Oct 2014" (PDF). line feed character in
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