The Intern At Work: Internal Medicine 200. A Window of Opportunity: Preventing and Treating HIV Opportunistic Infections
12 snips
Jun 27, 2023 AI Snips
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Episode notes
Start With ABCs And HIV Context
- Begin every evaluation with ABCs and vital signs, and call ICU early if the patient is unstable.
- Review recent CD4 count and viral load to contextualize symptoms and refine your differential diagnosis.
Suspect PCP Below CD4 200
- In patients with CD4 <200 who have cough or dyspnea, prioritize pneumocystis pneumonia in your differential.
- Look for indolent nonproductive cough and exertional dyspnea and obtain chest imaging and LDH to guide evaluation.
Think Histoplasmosis With CD4 <150
- For CD4 <150 and relevant exposures, suspect Histoplasma capsulatum and screen for disseminated disease.
- Ask about caves, bird or bat droppings, endemic travel, and examine for hepatosplenomegaly, lymphadenopathy, and skin lesions.