HUMAN IMMUNODEFICIENCY VIRUS INFECTION – CLINICAL MANIFESTATIONS (OTHER GROUPS 2)

Subgroup E—Other conditions

Defined as the presence of other clinical conditions which may be attributable to HIV infection but not listed above.

Although this system allows for ready classification for epidemiological purposes, patients typically present with one of the following:

Pulmonary presentations

P carinii pneumonia is the commonest presentation of AIDS. It usually presents with fever, non-productive cough and increasing dyspnoea of several weeks duratioa

Other infections may present as pulmonary disease including CMV, cryptococcosis and mycobacterial disease (including tuberculosis and atypical mycobacteriosis).

Gastrointestinal presentations

Oral candidiasis and oral hairy leukoplakia occur commonly.

Oesophageal candidiasis is suggested by dysphagia with retrosternal pain accompanied by oral candidiasis.

Low volume diarrhoea with weight loss and malaise is a frequent presentation of early AIDS. In many cases no specific pathogen is found. HIV can infect bowel mucosa and may be the sole aetiological agent for diarrhoea in some cases.

Diarrhoea associated with an opportunistic infection such as cryptosporidiosis, isosporiasis, CMV, and MAI may be severe with dehydration and extreme weight loss. Stools should also be examined for other pathogens including Salmonella sp. Shigella sp, Giardia lamblia, Clostridium difficile, Campylobacter sp and various enteroviruses.

Herpes can cause oesophagitis, proctitis or severe ulcerative perianal lesions.

Kaposi’s sarcoma or lymphoma may present with gastrointestinal symptoms.

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