Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- 96 HIV Infection: Initial Evaluation and Monitoring
- 97 HIV-1 Infection: Antiretroviral Therapy
- 98 Immune Reconstitution Inflammatory Syndrome
- 99 Differential Diagnosis and Management of Opportunistic Infections Complicating HIV Infection
- 100 Prophylaxis of Opportunistic Infections in HIV Infection
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
99 - Differential Diagnosis and Management of Opportunistic Infections Complicating HIV Infection
from Part XII - HIV
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- 96 HIV Infection: Initial Evaluation and Monitoring
- 97 HIV-1 Infection: Antiretroviral Therapy
- 98 Immune Reconstitution Inflammatory Syndrome
- 99 Differential Diagnosis and Management of Opportunistic Infections Complicating HIV Infection
- 100 Prophylaxis of Opportunistic Infections in HIV Infection
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Even in the era of highly active antiretroviral therapy (HAART), the preponderance of HIV-associated morbidity and mortality stems from opportunistic infections. And despite broad access to HIV screening tests in developed countries, opportunistic infections remain the first indication of HIV infection in a significant proportion of patients.
Barring a few exceptions, HIV-associated opportunistic infections (OIs) predictably manifest at discrete CD4 T-cell count boundaries below which the risk of symptomatic disease rises sharply (Figure 99.1). This enables physicians to calibrate clinical suspicions for specific OIs based on contemporaneous CD4 T-cell measurements. Current clinical approaches to the evaluation and management of HOIs are discussed in this chapter.
MUCOCUTANEOUS INFECTIONS
Candidal infections of the mouth manifest as thrush and, to a lesser extent, angular cheilitis. Thrush appears as white, loosely adherent deposits on the tongue, palate, or oropharynx. Most cases are asymptomatic; however, individuals with moderate-to-severe disease may report oropharyngeal discomfort, nausea, or dysgeusia. Treatment consists of topical or oral azoles (Table 99.1). Seborrhea dermatitis is a greasy, flaky, faintly erythematous rash. Facial involvement shows a predilection for the hairline of the forehead, eyebrows, bridge of the nose, and nasolabial folds. The role of Malazesia furfur infection in seborrhea dermatitis remains uncertain. Nonetheless, topical antifungal agents are effective in treating lesions, as are steroid creams (Table 99.1).
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 707 - 720Publisher: Cambridge University PressPrint publication year: 2008