0071643192.pdf

INFECTIOUS DISEASE

HIV NEUROPATHY

■ Rarely emergent
■ Painful sensory symptoms in feet

Gastrointestinal Complications

THRUSH(ORALCANDIDIASIS)

■ Candida albicans
■ Affects>80% of patients with AIDS
■ Whitish plaques that (unlike hairy leukoplakia) easily scrape off to leave
an erythematous base

ESOPHAGITIS

SYMPTOMS/EXAM

Odynophagia and/or dysphagia

DIFFERENTIAL

Candida, herpes simplex, CMV

TREATMENT

■ Empiric with antifungal
■ Nystatin wash or troche, fluconazole, or ketoconazole
■ F/U with endoscopy if persistent

DIARRHEA

Very common

DIFFERENTIAL

Normal bacterial organisms, Giardia, Cryptosporidium,Isospora belli, CMV,
M. avium intracellulare, antibiotic/HAART adverse reaction

HEPATOMEGALY(AIDS-ASSOCIATED)

■ Elevated alkaline phosphatase is disproportionately high compared to other
LFTs.
■ Jaundice is rare.
■ Consider coinfection with Hepatitis B and/or C (HBV/HCV).

PROCTITIS

SYMPTOMS/EXAM

Tenesmus
Pain with defecation
Rectal discharge

DIFFERENTIAL

Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, HSV,
fissures, masses.

Hairy leukoplakia (unlike oral

candidiasis) is normally

located on the lateral portions

of the tongue.