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Cytomegalovirus (CMV) infection
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
CMV choroidoretinitis can lead to blindness
Adrenal involvement causes
  • lassitude (weariness)
  • postural hypotension {lowering of BP due to change in posture}
  • dehydration
CMV encephalitis usually presents sub acutely with
  • personality change
  • poor concentration
  • headaches
  • insomnia (lack of sleep)
Treatment
CMV infections are usually treated by
  • Antiviral drugs
Mycobacterium Tuberculosis
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
Treatment
Anti-tuberculosis drugs are used. Prophylaxis with a anti-tuberculous drug is generally given to prevent relapse.
 
For prevention of TB - Chemoprophylaxis is recommended.
 
Atypical Mycobacteria
Mycobacterium avium intracellulare (MAI)
  
Common features
  • persistent high-grade fever
  • night sweats
  • anaemia
  • weight loss
  • malaise (weariness)
  • anorexia (loss of appetite)
  • diarrhoea
  • muscle pain
Signs
  • Tender lymphadenopathy. 
  • Hepatomegaly. 
  • Investigation: Chest x-ray and CT scan
Treatment

Antibiotics are generally used in combinations.

Candidosis
  • Oral
  • Oesophageal
Management
Continuous anti-fungal therapy .
 
Toxoplasmosis - Protozonal Infection
  • Common site of involvement: Brain.
  • Retina (photosensitive layer of eye) may also be involved.
      
Symptoms and Signs
  • fever
  • lymphadenopathy
  • headache
  • convulsions
  • cognitive impairment
  • confusion
  • lethargy
  • coma
Treatment
Generally used drugs are
  • Antibiotics  
  • Steroids 
  • Anticonvulsants
  • Maintenance therapy is recommended
Cryptococcosis - Cryptococcal Infection
Crytococcus neoformans causes: meningitis, pulmonary involvement.
 
Signs and Symptoms
  • Headache
  • Nausea
  • Vomiting
  • Photophobia
  • Fever
  • Weight loss
Investigations
  • CSF examination
  • Indian ink staining of the CSF
  • CSF culture
  • measurement of Cryptococcal antigen both in serum and CSF.
  • CT scan of the brain.
Treatment
Drugs commonly used are: Anti-fungal agents.
Histoplasmosis - Causative Organisms
  • Histoplasma capsulatum
  • Coccidioidomyces immitis  
Treatment
 Anti-fungal agents are generally used.
  
Nematode Infection
Causative agent is Strongyloides stercoralis 
 
Treatment
Anti-helminthic drugs are generally used.

 

 

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