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Showing posts from 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.