Clinical Conditions Associated with AIDS – Opportunistic Infections
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.
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