Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-26T23:03:47.323Z Has data issue: false hasContentIssue false

99 - Differential Diagnosis and Management of Opportunistic Infections Complicating HIV Infection

from Part XII - HIV

Published online by Cambridge University Press:  05 March 2013

Anthony Ogedegbe
Affiliation:
Weill Cornell Medical College
Marshall J. Glesby
Affiliation:
Weill Cornell Medical College
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
Get access

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
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×