
The Clinical Problem Solvers Episode 295: Rafael Medina Subspecialty Series – fatigue in patient living with HIV
Jul 12, 2023
AI Snips
Chapters
Transcript
Episode notes
Think Multiple Concurrent Processes
- Patients with very low CD4 counts can have multiple simultaneous opportunistic processes.
- Monica Gandhi emphasizes broad differentials across bacterial, fungal, parasitic, and viral categories.
Prioritize Targeted Physical Exam And Eye Exam
- Perform a focused exam including eyes, mouth, cranial nerves, heart, and skin to look for opportunistic signs.
- Get an ophthalmology consult and assess for raised intracranial pressure before LP.
Rapid Comprehensive Diagnostic Workup
- Get head imaging (CT to allow LP safety, MRI when possible) and send a broad CSF panel including fungal, AFB, viral PCRs.
- Order serum CrAg, TB testing, chest imaging, and relevant serologies promptly.


