14385031
Description
Mind Map by Amalin Najiha Mohd Sabri, updated more than 1 year ago
|
Created by Amalin Najiha Mohd Sabri
over 6 years ago
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|
HIV Clinical
Presentation
and
Opportunistic
Infections
- Clinical categories (CD4)
- 1. PGL
- > LN involving >2
noncontiguous sites other
than inguinal nodes.
- > LN involving >2
noncontiguous sites other
than inguinal nodes.
- 2. B-sympt.
- 3. C- AIDS Indicator conditions
- 1. PGL
- Natural progression
- WHO Clinical Staging
- Clinical presentation
- 1. Primary infection
(2 w in average)
- • 50 - 90% get some symptoms • 1
– 6 weeks incubation • Often
unrecognised • fever >95%, •
lymphadenopathy 74%, •
pharyngitis 70% • rash (5-10 mm
maculo- papular on face, trunk,
palms) • myalgia/arthralgia 54% •
diarrhoea32%, • headache 32%, •
nausea/vomiting 29%, •
Neurological symptoms in 50%:
headache, meningitis,
encephalitis • Occasionally
thrush
- • 50 - 90% get some symptoms • 1
– 6 weeks incubation • Often
unrecognised • fever >95%, •
lymphadenopathy 74%, •
pharyngitis 70% • rash (5-10 mm
maculo- papular on face, trunk,
palms) • myalgia/arthralgia 54% •
diarrhoea32%, • headache 32%, •
nausea/vomiting 29%, •
Neurological symptoms in 50%:
headache, meningitis,
encephalitis • Occasionally
thrush
- 2. Opportunistic
infection/Malignancy
(2ndary to immune
suppression)
- Resp
- Sinusitis, TB,
PCP, Bacterial
pneumonia,
Kaposi's
sarcoma
- Sinusitis, TB,
PCP, Bacterial
pneumonia,
Kaposi's
sarcoma
- GIT
- oral thrush, Hairy
leukoplakia,
candida, esophageal
thrush, CMV
esophagitis
- oral thrush, Hairy
leukoplakia,
candida, esophageal
thrush, CMV
esophagitis
- Hepatic
- Hep B and C, drug
induced hepatitis,
acalculous cholecystitis,
AIDS cholangiopathy,
lactic acidosis,
pancreatitis,
hyperamylasaemia,
pancear infection
- Hep B and C, drug
induced hepatitis,
acalculous cholecystitis,
AIDS cholangiopathy,
lactic acidosis,
pancreatitis,
hyperamylasaemia,
pancear infection
- Neuro
- CNS diffuse
- CNS focal
- • Cerebral toxoplasmosis • Primary
CNS lymphoma • Progressive
multifocal leucoencephalopathy
(PML) • Varicella zoster encephalitis •
CMV encephalitis • Herpes simples
encephalitis • Brain abscess (i.e
tuberculosis, Nocardia, bacterial,
aspergillus)
- • Cerebral toxoplasmosis • Primary
CNS lymphoma • Progressive
multifocal leucoencephalopathy
(PML) • Varicella zoster encephalitis •
CMV encephalitis • Herpes simples
encephalitis • Brain abscess (i.e
tuberculosis, Nocardia, bacterial,
aspergillus)
- Crytococcal Meningitis
- Peripheral neuropathy
- Demential
- Impaired short-term memory, Clumsiness,
Slowness, apathy, irritability, Poor
concentration, Personality change
- Pathogenesis
- - Stage
correlates w
CSF HIV viral
RNA
- Infection of brain
macrophages, neurons die
- - Stage
correlates w
CSF HIV viral
RNA
- Impaired short-term memory, Clumsiness,
Slowness, apathy, irritability, Poor
concentration, Personality change
- Cerebral toxoplasmosis
- Headache 50-70%
- Altered mental status
- Focal signs 60%
- seizures 30%
- CD4 <100, Serum IgG+
- Headache 50-70%
- Primary CNS lymphoma
- Progressive multofocal
leuconencephalopathy
(PML)
- Viral encephalitis
- CNS diffuse
- Skin
- Seborrheic dermatitis,
Dermatophytosis, Dry-skin syndrome,
HIV assoc. pruritis, Eosinophilic
folliculitis, Fungal infections, VZV or
HSV, psoriasis, scabies
- Kaposi Sarcoma
- Round or irregular, pink-red to violaceous,
macules to papules, palpable, firm, not tender,
later become confluent, large masses all over
- Round or irregular, pink-red to violaceous,
macules to papules, palpable, firm, not tender,
later become confluent, large masses all over
- Molluscum contagiosum
- 2-5mm pink papules w central umbilication
- 2-5mm pink papules w central umbilication
- Norwegian scabies
- Seborrheic dermatitis,
Dermatophytosis, Dry-skin syndrome,
HIV assoc. pruritis, Eosinophilic
folliculitis, Fungal infections, VZV or
HSV, psoriasis, scabies
- Renal
- CMV retinitIs, low CD4
- CMV retinitIs, low CD4
- Resp
- 4. Complications due to
HIV
- • Encephalitis • Peripheral Neuropathy •
Pericarditis • Myocarditis •
Cardiomyopathy • Pulmonaryvascular
disease and pulmonary hypertension •
Valvular disease • Anincreased
incidence of coronary artery disease •
Cardiomyopathy • Myocarditis •
Cardiomyopathy • Pulmonary vascular
disease and pulmonary hypertension •
Valvular disease • Anaemia, bone
marrow failure • Hepatitis • Pancreatitis
- • Encephalitis • Peripheral Neuropathy •
Pericarditis • Myocarditis •
Cardiomyopathy • Pulmonaryvascular
disease and pulmonary hypertension •
Valvular disease • Anincreased
incidence of coronary artery disease •
Cardiomyopathy • Myocarditis •
Cardiomyopathy • Pulmonary vascular
disease and pulmonary hypertension •
Valvular disease • Anaemia, bone
marrow failure • Hepatitis • Pancreatitis
- 1. Primary infection
(2 w in average)
- Differential dx
- EBV Infection: Mononucleosis
- CMV infection
- Toxoplasmosis
- Rubella
- Syphilis
- Primary herpes infection
- Viral hepatitis
- Drug reactions
- EBV Infection: Mononucleosis
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