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Opportunistic Infections in HIV Patients
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What are the CD4 breakpoints for Opportunistic Infection prophylaxis in HIV patients?
< 200
:
Pneumocystis jiroveci
< 100
:
Toxoplasma gondii
< 50
:
MAC
CMV (also need to be CMV +)
Just secondary prevention
:
Cryptococcus neoformans
Which pathogens may cause Immune Reconstitution Inflammatory Syndrome (IRIS) when starting a new ARV regimen?
Pneumocystis jiroveci
MAC
CMV
What is the treatment for Pneumocystis jiroveci?
Bactrim IV 15-20mg/kg/d (high dose) QID x 21d
Pentamidine IV
Clindamycin + Primaquine (test for G-6PD deficient)
Dapsone + Trimethoprim
Atovaquone (mild cases only)
Adjuvant
: methylprednisolone (change to prednisone after 3-4d)
What is the prophylaxis for Pneumocystis jiroveci?
Bactrim PO
Pentamidine inhalation
Atovaquone
Dapsone
Dapsone + pyramthamine + Leucovorin
What is the treatment for Toxoplasma gondii?
Pyramethamine + Leucovorin + Sulfadiazine
Pyramethamine + Leucovorin + Clindamycin
Bactrim
Atovaquone + Sulfadiazine
Atovaquone
Pyramethamine + Azithromycin
What is the prophylaxis for Toxoplama gondii?
Bactrim
Atovaquone
Dapsone + Pyramethamine + Leucovorin
What is the treatment for Cryptococcus neoformans?
[AMBd or LAMB] + Flucytosine x 2wks, then Fluconazole x 8wks
Fluconazole +/- Flucytosine (IF AMB intolerable)
Adjuvant
: therapeutic lumbar taps
What is the prophylaxis for Cryptococcus neoformans?
Fluconazole
Itraconazole
What is the treatment for Mycobacterium avium complex (MAC)?
Clarithrymycin + Ethambutol +/- Rifabutin continued indefinitely
What is the prophylaxis for MAC?
Azithromycin
Clarithromycin
Rifabutin
What is the treatment for CMV?
Ganciclovir
Valgancyclovir
Foscarnet
Ganciclovir retinal implant
Cidofovir + Probenecid (hydrate!)
What is the prophylaxis for CMV?
Valgancyclovir
What is the treatment for Candida infections in HIV?
Fluconazole 100mg x 7-14d(oral infection)
Fluconazole 400mg x 14-21d (esophageal infection)
Nystatin
Clotrimazole troche
What is the treatment for Fluconazole-resistant Candida infections in HIV?
Oral
:
Itraconazole
AMBd
Esophageal
:
Posaconazole
Voriconazole
Caspofungin
Micafungin
Anidulafungin
LAMB
What is the treatment for Cryptosporidiosis?
Nitazoxanide
Paromomycin
Macrolides
What is the treatment for microsporidiosis?
Albendazole
Author
giddyupp
ID
64046
Card Set
Opportunistic Infections in HIV Patients
Description
Opportunistic Infections in HIV Patients
Updated
2011-02-04T16:49:16Z
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