Clinical Conditions Associated with the Diagnosis of AIDS

Opportunistic Infections happens CD4 T cells count  is less than between 200-400/mm3

Herpes Simplex 

Viral Infection

Passed from direct contact with infected person

Mucotaneous infection(most common)

Chronic oral ulcers, pneumonitis, bronchitis, esophagitis, colitis, keratitis (corneal tear, pain, photophotophobia), genital herpes

CNS Infection – occur sporadically, but can be severe

CytoMegalo Virus (CMV) Disease 

GI tract (other than liver, spleen and lymph node)

Most common illness is retinitis

Death of the cells in the back of the eyes

light flashes, decreased or distorted vision, or blind spots

Some patients who have recently started using ARTVs can get inflammation in their eyes, causing loss of vision. This is called immune restoration syndrome

Diarrhea, fever, weight loss

Histoplasmosis 

a fungal infection

Fever, chills, cough (hemoptysis), chest pain when inhaling, diaphoresis

Once disseminated – headache, mouth and skin lesions, neck stiffness

Pneumocystis Carinii Pneumonia 

Most common serious infection

Fungal infection of the lung

Dry cough, fever, SOB, rapid breathing

This organism is common in the environment and does not cause illness in healthy people

Pneumonia vaccine doesn’t prevent,  but sulfa based antibiotic Bactrim can.

if your CD4 cell count falls below 200.  Your doctor may also put you on Bactrim if you show certain symptoms, such as having a temperature above 100°F that lasts for 2 weeks or longer, or if you get a fungal infection in the mouth or throat. Having thrush is believed to raise your risk for getting PCP.

Cryptococcus 

Yeast like fungal infection

Found in soil – gets into body when breathing

No evidence of spread from person to person

Brain – encephalomeningitis affecting brain and spinal cord.

CSF test. Fever, fatigue, a stiff neck, headache, nausea and vomiting, confusion, blurred vision or sensitivity to bright lights.

Skin, Blood and Lung, extrapulmonary

For some people, draining spinal fluid daily to reduce pressure on the brain is also part of treatment.

Cryptococcal meningitis comes back after the first time in about half of the people who get it. Repeat cases are reduced if people keep taking antifungal drugs. However, study shows no recurrence of meningitis in people whose CD4 increased to more than 100 and who had an undetectable viral load for 3 months.

Anti-fungal drugs such as amphotericin B, fluconazole, and flucytosine.

Candida Infection 

Yeast like fungal infection

Mouth (thrush)

Respiratory tract

Bronchi, esophagus, lungs

Skin, Brain, Heart

This yeast is found in most people’s bodies.

Candida Diet

Avoid sugar, alcohol, wheat, yeast, caffeine (Caffeine prompts the liver to dump large doses of sugar into the blood stream), preservatives and additives, refined and processed foods, moldy foods, dairy (except yogurt and butter on occasion), cheese and milk contain lactose (milk sugar) which the yeast will feed on (some people can do small amounts of cottage cheese)

There is no way to prevent exposure to candida. Medications are not normally used to prevent candidiasis. There are several reasons for this:

It is not very dangerous.

There are effective drugs to treat it.

The yeast could develop resistance to the medications.

Mycobacterium Infections 

Mycobacterium Avium Complex

Extrapulmonary and disseminated

CD4 count <50

Affects small and large bowel, liver, esophagus and intra-abdominal lymph nodes

fevers, diarrhea, malabsorption, anorexia, nigh sweats, malaise and can disseminate to the bone marrow

They are found in water, soil, dust and food. Almost everyone has them in their body

Culturing of blood, urine and saliva

Combination antiretroviral therapy can make your CD4 cell count go up. If it goes over 100 and stays there for 3 months, it may be safe to stop taking medications to prevent MAC.

Mycobacterium Kansasii 

Second most non-tuberculosis mycobacterium infection in AIDS patients

Mimics pulmonary infection of tuberculosis but rarely disseminated

In Disseminated Tuberculosis 

Bones and joints

Bronchus

Cervical lymph nodes

Eye

Larynx (voice box)

Lining of the abdominal cavity (peritoneum)

Lining of the brain and spinal cord (meninges)

Lining of the heart (pericardium)

Organs of the male or female urinary and reproductive systems

Skin

Small bowel

Stomach

Cough, fever, chest pain, sputum production

Toxoplasmosis 

Most Common Parasitic Infection

Brain (most common), lungs, heart, eyes

Fever, chills, retinal inflammation with visual disturbances, confusion,  poor coordination, seizures

Recurrent Salmonella Septicemia

Undercooked meat, eggs or unpasteurized milk.

Water, soil, kitchen surfaces

Diarhea, fever

The risk of toxo is highest when your CD4 cell (T-cell) counts are below 100.

Toxo antibody testm, brain scans by CT scan or MRI scan are also used to diagnose toxo.

The toxoplasma gondii parasites need vitamin B to live. Pyrimethamine stops toxo from getting vitamin B. Sulfadiazine prevents toxo from using it.

These drugs both interfere with vitamin B and can cause anemia. People with toxo usually take leucovorin, a form of folic acid (a B vitamin), to prevent anemia.

Other Clinical Conditions 

Encephalopathy

Non-Hodgkins Lymphoma

Kaposi’s Sarcoma

Isosporiasis

Parasite isospora infects epithelial lining of the small intestine

References:

Clinical Conditions Associated with Diagnosis of AIDS Presentation

To Get Checked Up for Any Conditions Associated with AIDS, visit these resources:

mnaidsproject.org

aidsinfo.nih.gov

aids.org/factsheets/500-opportunistic-infections.html

avert.org/hiv-opportunistic-infections.htm

References:

AEGIS. “Opportunistic Infections – AIDS & HIV.” Opportunistic Infections. Web. 31 Aug. 2010. <http://www.aegis.com/topics/oi/>.

AIDS.org. “OPPORTUNISTIC INFECTIONS.” Educating – Raising HIV Awareness – Building Community. Web. 31 Aug. 2010. <http://www.aids.org/factsheets/500-opportunistic-infections.html>.

Daniels, R., & Daniels, R. (2004). Nursing fundamentals: caring and clinical decision making. Clifton Park, NY: Delmar Learning.

“HIV AIDS Related Opportunistic Infections National Library of Medicine.” National Institutes of Health. U.S. National Library of Medicine, 16 Apr. 2010. Web. 31 Aug. 2010. <http://sis.nlm.nih.gov/hiv/opportunisticinfections.html>.

“HIV Related Opportunistic Infections: Prevention and Treatment.” AIDS & HIV Information from the AIDS Charity AVERT. Avert.org, 14 July 2010. Web. 31 Aug. 2010. <http://www.avert.org/hiv-opportunistic-infections.htm>.

Rosdahl, C. B., & Kowalski, M. T. (2008). Textbook of Basic Nursing (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.