Updated: 8/7/2017

Infections in AIDS

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 Bugs Causing Infection in HIV+ Adults

Bacteria
Disease Notes
Mycobacterium avium-intracellulare TB-like Especially CD4 < 50
Bartonella henselae Bacillary angiomatosis Superficial vascular proliferation
Virus
Disease Notes
CMV CMV retinitis, pneumonia "Cotton-wool spots" on fundoscopic exam in retinitis, Cowdry type A intranuclear inclusion bodies
EBV Oral hairy leukoplakia (OHL), Non-Hodgkin's lymphoma   --
HPV Squamous cell carcinoma Anus or cervix
HHV-8 Kaposi's sarcoma  --
JC virus Progressive multifocal leukoencephalopathy (PML) White matter damage in CNS, demyelination
Fungi
Disease Notes
Histoplasma capsulatum Histoplasmosis (pneumonia), hepatosplenomegaly, fever Disseminated disease only in immunocompromised
Candida albicans Thrush, esophagitis White plaque on oral mucosa
Cryptococcus neoformans Meningitis, encephalitis Most common meningitis in AIDS
Aspergillus fumigatus Invasive aspergillosis Pleuritic pain, hemoptysis
Pneumocystis jiroveci "PCP" ("P. carinii" pneumonia) Especially CD4 < 200
Protozoa
Disease Notes
CryptosporiDium Diarrhea Acid-fast cysts in stool
Toxoplasma gondii Brain abscesses Ring-enhancing lesions 
 

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Questions (2)

(M1.MC.14.79) A 55-year-old male presents to his primary care doctor with several weeks of headaches and low-grade fevers. His medical history is notable for a motor vehicle accident when he was in his 20's that required multiple blood transfusions, and three separate courses of antibiotics for pneumonia in the past 2 years. Review of systems reveals 10-pound weight loss in last 3 months. He has notable left-sided weakness while walking into the clinic, and, on further exam, he has markedly slurred speech and cervical, axial, and inguinal lymphadenopathy is present. A head CT is ordered, which is shown in Figure A. What is the most likely diagnosis? Tested Concept

QID: 106894
FIGURES:
1

Neurocysticercosis

14%

(6/43)

2

Toxoplasmosis

51%

(22/43)

3

Progressive multifocal leukoencephalopathy

12%

(5/43)

4

Lymphoma

7%

(3/43)

5

Cryptococcosis

14%

(6/43)

L 2 E

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(M1.MC.13.53) A 28-year-old male with a history of HIV infection is found to have a CD4+ T lymphocyte count of 68 cells per microliter. As a consequence of his HIV infection, this patient is at increased risk of malignancy due to which of the following? Tested Concept

QID: 101512
1

Pneumocystis jiroveci

30%

(18/60)

2

HHV-6

18%

(11/60)

3

Actinomyces israelii

2%

(1/60)

4

Helicobacter pylori

0%

(0/60)

5

Epstein-Barr Virus (EBV)

47%

(28/60)

L 4 E

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Topic COMMENTS (4)
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