0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54
382 Complications of Human Immunodeficiency Virus Type 1■Eye: HIV retinopathy; if CD4<50-100/mm^3 , CMV and much less fre-
quently toxoplasma gondii, HSV, VZV, pneumocystis; other agents
include syphilis, candida and drugs (rifabutin, cidofivir, clofaza-
mine)
■Dermatologic Disease: Bartonella hensela or quintana (bacil-
lary angiomatosis), HSV, VZV (herpes zoster), Kaposi sarcoma
(HHV-8), molluscum contagiosum, Staphylococcus aureus, syphilis,
eosinophilic folliculitis, psoriasis, drug reaction, also Cryptococcus
neoformans and Histoplama capsulatum if CD4 <100–200/mm^3
■Oral Lesions: candida (thrush), EBV (oral hairy leukoplakia, OHL),
HSV, KS (HHV-8), aphthous ulcers
■Esophagitis/Esophageal Ulcers: candida (50–70%), CMV (10–20%),
aphthous ulcers (10–20%), HSV (2.5%)
■Diarrhea– acute: salmonella (5–15%), shigella (1–3%), Campylobac-
ter jejuni (4–8%), Clostridium difficile (10–15%), E. coli (10–20%),
enteric viruses (15–30%), idiopathic (25–40%), drug reaction
■Diarrhea – chronic: microsporidia; E. bieneusi, S. intestinalis, cryp-
tosporidium, CMV, MAC, Isospora, Entamoeba histolytica, Giar-
dia lamblia, Cyclospora cayetanensis, idiopathic, small bowel over-
growth, lymphoma, drug reaction
■Pulmonary Infection– acute: streptococcus pneumonia, Haemo-
philus influenzae; uncommonly Staphylococcus aureus, Legionella,
and Aspergillus
■Pulmonary infection – chronic or subacute: Pneumocytis carinii; M.
tuberculosis, rarely M. kansasii or nocardia; cryptococcus, Histo-
plasma capsulatum, Coccidiodes immitis, Aspergillus, Rhoddococ-
cus; Candida and CMV are common isolates but rare cause of pul-
monary disease; MAC may colonize respiratory tract but rarely a
cause of pulmonary disease; also lymphocytic interstitial pneumo-
nia (LIP)
■Central Nervous System Disease: HIV-associated dementia (20%),
cryptococcus meningitis (8-20%), toxoplasmosis (3–10%), JC virus
(PMLE, 2–4%), lymphoma (1–2%), neurosyphilis (0.5%), CMV (0.5%),
tuberculosis (0.5–1.0%)
■Constitutional Symptoms: lymphoma, TB; if CD4 <200/mm^3 , think
PCP, lymphoma, HIV and if <100/mm^3 , MAC, CMV, HIV, and Histo-
plasma capsulatum
■Fever of Unknown Origin (FUO) in AIDS: MAC (31%), PCP (13%),
CMV (11%), bacterial pneumonia (9%), lymphoma (7%), sinusi-
tis (6%), bartonella (8.5%), catheter infection (1–10%), drug allergy ̃
(2–5%); also disseminated histoplasmosis (7%), leishmaniasis, TB