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Cytomegalovirus (CMV) infection
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CMV is a herpes virus.
Clinical disease is usually due to reactivation of latent CMV infection due to severe
immunosuppression.
Organs usually involved are
- eyes
- central nervous system
- liver
- gut
- adrenals
- mouth
- lungs
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CMV choroidoretinitis
can lead to blindness |
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Adrenal involvement
causes |
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- lassitude (weariness)
- postural hypotension {lowering of BP due to change in posture}
- dehydration
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CMV encephalitis
usually presents sub acutely with |
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- personality change
- poor concentration
- headaches
- insomnia (lack of sleep)
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Treatment |
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CMV infections are usually treated
by
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Mycobacterium
Tuberculosis
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The main features of tuberculosis in HIV infection
are
- Most cases are due to reactivation
- TB may precede AIDS in HIV infected individual
- Extra pulmonary TB in HIV is an AIDS-defining diagnosis
- Prognosis poor----TB may accelerate HIV disease
- Threat of multi-drug resistant TB
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Treatment
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Anti-tuberculosis
drugs are used. Prophylaxis with a anti-tuberculous drug is generally given to prevent relapse.
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For prevention of TB
- Chemoprophylaxis is recommended.
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Atypical
Mycobacteria
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Mycobacterium avium intracellulare
(MAI)
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Common features |
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- persistent high-grade fever
- night sweats
- anaemia
- weight loss
- malaise (weariness)
- anorexia (loss of appetite)
- diarrhoea
- muscle pain
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Signs |
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- Tender
lymphadenopathy.
- Hepatomegaly.
- Investigation: Chest x-ray and CT scan
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Treatment
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Antibiotics are generally used in combinations.
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Candidosis |
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Management |
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Continuous anti-fungal therapy .
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Toxoplasmosis -
Protozonal Infection
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- Common site of involvement: Brain.
- Retina (photosensitive layer of eye) may also be involved.
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Symptoms and Signs |
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- fever
- lymphadenopathy
- headache
- convulsions
- cognitive impairment
- confusion
- lethargy
- coma
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Treatment |
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Generally used drugs
are |
- Antibiotics
- Steroids
- Anticonvulsants
- Maintenance therapy is recommended
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Cryptococcosis -
Cryptococcal Infection
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Crytococcus neoformans causes: meningitis,
pulmonary involvement.
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Signs and Symptoms |
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- Headache
- Nausea
- Vomiting
- Photophobia
- Fever
- Weight loss
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Investigations |
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- CSF examination
- Indian ink staining of the CSF
- CSF culture
- measurement of Cryptococcal antigen both in serum and CSF.
- CT scan of the brain.
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Treatment |
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Drugs commonly
used are: Anti-fungal agents.
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Histoplasmosis -
Causative Organisms |
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- Histoplasma capsulatum
- Coccidioidomyces immitis
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Treatment
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Anti-fungal
agents are generally used.
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Nematode
Infection
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Causative agent is
Strongyloides stercoralis
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Treatment
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Anti-helminthic
drugs are generally used.
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