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TABLE Clinical Manifestation of AIDS System condition comments Pulmonary Communityacquired bacterial pneumonia PCP Tuberculosis Other infections Nervous system AIDS dementia Toxoplasmosis Cryptococcal meningitis Other CNS infections Noninfectious CNS diseases Gastrointestinal Diarrhea Oral lesions Esophageal involvement Anorectal disease Dermatologic Kaposis sarcoma Infections Recurrent bacterial pneumonia two or more episodes per year is times more common in HIV patients with low CDcell counts mm than in those with normal counts Seventy percent of patients acquire PCP at some point often the initial opportunistic infection establishes the diagnosis of AIDS Leading cause of death in patients with AiDS Occurs when cD count is Clinical findings fever nonproductive cough shortness of breath with exertion at first then occurring at rest CXR diffuse interstitial infiltrates negative radiographs in of patients with PCP Treatment TMPSMX PO or IV for weeks steroid therapy if patient is hypoxic or has elevat ed Aa gradient Prophylaxis Oral TMPSMX dose daily is recommended Negative PPD test results are frequent among AIDS patients due to immunosuppression CMV or MAC increased risk when the cD count Cryptococcus neoformans Histoplasma capsulatum neoplasms Kaposis sarcoma Progressive process in of patients Early stages subtle impairment of recent memory and other cognitive deficits Later stages changes in mental status aphasia motor abnormalities Usually a reactivation of latent infection of Toxoplasmosis gondii Symptoms both of a mass lesion discrete deficits headache and of encephalitis fever altered mental status CT scan or MRI shows characteristic findings multiple more than three contrastenhanced mass lesions in the basal ganglia and subcortical white matter Diagnosed by identifying organisms in CSF by cryptococcal antigen culture or staining with india ink Treat with amphotericin B for days. <a href=h...
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