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10 Cards in this Set
- Front
- Back
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Factors influencing whether an HIV patient will develop an opportunistic infection
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(1) Immune status (CD4 count)
(2) Exposure (3) Virulence of pathogen |
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OI: Bacterial Pneumonia
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Pulmonary disorders are the leading cause of morbidity/mortality in HIV patients
Pneumococcus is the leading etiological agent Resolve? Give them the pneumococcal vaccine! |
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OI: PCP
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Pneumocystis Pneumonia
Pneumocystic jiroveci is a ubiquitous fungus Clinical presentation: insidious onset, fever, night sweats, non-productive cough; diffuse, bilateral intersitial infiltrates (on CXR) Treatment: Bactrim and/or steroids (if concerned about breathing problems) |
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OI: PCP
(Prophylaxis?) |
Absolutely
Give Bactrim to patients w/CD4 count <200 NOTE: medication can be discontinued when CD4 count improves |
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When should you administer PCP prophylaxis?
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When CD4 count drops below 200
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OI: Candida
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Problem when CD4 count nears 200
Treatment: PRN fluconazole therapy (preferred over chronic suppression) |
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OI: MTB
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Mycobacterium Tuberculosis
Do annual PPD screening and follow positives w/CXR (will see apical infiltrates) |
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OI: Mycobacterium avium complex
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Disseminated disease that presents most often in patients w/CD4 counts less than 50
Treatment: azithromycin |
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Patients w/CD4 count <50
(prophylatic considerations) |
MAC attack, give weekly azithromycin
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What pathogen should you consider as a patient's CD4 count drops below 50?
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MAC
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