• OIs that affect the GI tract
  • CD4 count < 200: Shigella, Campylobacter, Salmonella, E. coli, Yersinia, Norovirus
  • CD4 count < 100: Esophageal candidiasis
  • CD4 count < 50: MAC, CMV (more systemic infections), visceral KS
  • All CD4 counts: C Diff
  • Proctitis - HSV, HPV, Gonorrhea, Chlamydia
  
  

  Posted 08/02/16 09:16:26 AM by Anna Krigel

• PCP diagnosis:
  • Microscopy with staining (often with Gomori methenamine silver stain) of an induced sputum specimen or BAL fluid is necessary as Pneumocystis cannot be cultured
  • Beta-D-glucan assay (Fungitell) has been shown to have a sensitivity of 92% and specificity of 86% for detecting PCP
  • Serum LDH has a high sensitivity for PCP but poor specificity
  
  

  Posted 08/02/16 09:51:22 AM by Anna Krigel

• Kaposi sarcoma management:
  • All patients are recommended for antiretroviral therapy, though the initiation of ART has been associated with the progression of KS as part of IRIS
  • Small skin lesions can be treated locally with intralesional vinblastine
  • Systemic chemotherapy is typically with Doxil (pegylated liposomal doxorubicin) and used for disease with widespread skin involvement or symptomatic visceral involvement
  
  
  
  

  Posted 08/02/16 10:09:55 AM by Anna Krigel

• For further reading...

  Serum Indicators for the Diagnosis of Pneumocystis Pneumonia
  IRIS associated with KS
  
  

  Posted 08/02/16 10:11:29 AM by Anna Krigel

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