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
QUESTIONS 1 of 2 1 2 Previous Next (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? QID: 106894 FIGURES: A Type & Select Correct Answer 1 Neurocysticercosis 11% (9/85) 2 Toxoplasmosis 51% (43/85) 3 Progressive multifocal leukoencephalopathy 11% (9/85) 4 Lymphoma 4% (3/85) 5 Cryptococcosis 24% (20/85) M 2 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (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? QID: 101512 Type & Select Correct Answer 1 Pneumocystis jiroveci 37% (38/103) 2 HHV-6 16% (16/103) 3 Actinomyces israelii 1% (1/103) 4 Helicobacter pylori 2% (2/103) 5 Epstein-Barr Virus (EBV) 43% (44/103) M 4 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic