Tuesday 6 October 2009

HIV AND "SKIN"

Fungal/yeast

1 Candida (oral or oesophageal)
2 Tinea infections (corporis,
cruris, pedis, interdigitale etc)
3 Pityriasis versicolor
4 Seborrhoeic dermatitis
(especially when severe or
recalcitrant)
5 Pityrosporum folliculitis

Viral

1 Herpes zoster
2 Herpes simplex
3 Viral wart infections
4 Molluscum contagiosum
Bacterial
5 Staphylococcus aureusimpetigo,
chronic folliculitis
Mycobacterial
6 M tuberculosis
Infestations
7 Scabies (especially Norwegian
scabies)

Other

1 Psoriasis
2 Kaposi’s sarcoma
3 Acne

All of these skin conditions can
occur without HIV, but consider
HIV particularly if they are
recalcitrant, recurrent or atypical.

HIV Presentation

Acute HIV-related conditions that may present in the emergency
department




1. Community acquired bacterial pneumonia. People with HIV, regardless of their level of
immunosuppression, are more at risk of bacterial pneumonia. They have similar signs
and symptoms to the non-HIV-infected population, eg fever, cough, dyspnoea,
increased respiratory rate and sputum production.

2. TB presents with malaise, weight loss, night sweats, fever, cough, sputum production
(may be blood-stained), and lymphadenopathy.
3. Pneumocystis pneumonia (PCP) presents with exertional dyspnoea, fever, dry cough,
normal auscultation. X-ray typically shows perihilar shadowing (ground glass haze),
but may be normal.
4. Cryptococcal meningitis. This presents with headache, with or without classical signs
of meningism. Occasionally rapid progression occurs, and the patient may present in
coma.
5. Cerebral toxoplasmosis. This may present with headache, fever, lethargy and
confusion, progressing to fits and coma.

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