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.
