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14385031
HIV Clinical Presentation and Opportunistic Infections
Description
Undergraduate Medicine Tropical Medicine Mind Map on HIV Clinical Presentation and Opportunistic Infections, created by Amalin Najiha Mohd Sabri on 13/07/2018.
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tropical medicine
undergraduate medicine
Mind Map by
Amalin Najiha Mohd Sabri
, updated more than 1 year ago
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Created by
Amalin Najiha Mohd Sabri
over 6 years ago
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Resource summary
HIV Clinical Presentation and Opportunistic Infections
Clinical categories (CD4)
1. PGL
> LN involving >2 noncontiguous sites other than inguinal nodes.
2. B-sympt.
3. C- AIDS Indicator conditions
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
2. Opportunistic infection/Malignancy (2ndary to immune suppression)
Resp
Sinusitis, TB, PCP, Bacterial pneumonia, Kaposi's sarcoma
GIT
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
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)
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
Cerebral toxoplasmosis
Headache 50-70%
Altered mental status
Focal signs 60%
seizures 30%
CD4 <100, Serum IgG+
Primary CNS lymphoma
Progressive multofocal leuconencephalopathy (PML)
Viral encephalitis
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
Molluscum contagiosum
2-5mm pink papules w central umbilication
Norwegian scabies
Renal
CMV retinitIs, low CD4
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
Differential dx
EBV Infection: Mononucleosis
CMV infection
Toxoplasmosis
Rubella
Syphilis
Primary herpes infection
Viral hepatitis
Drug reactions
Media attachments
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