Download Internal Medicine - The Carter Center

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts

Infection wikipedia, lookup

Disease wikipedia, lookup

Management of multiple sclerosis wikipedia, lookup

Multiple sclerosis research wikipedia, lookup

List of medical mnemonics wikipedia, lookup

Dental emergency wikipedia, lookup

Sjögren syndrome wikipedia, lookup

Adherence (medicine) wikipedia, lookup

Syndemic wikipedia, lookup

Focal infection theory wikipedia, lookup

Transcript
Internal Medicine
ƒ
Erythematous Form : there is predominantly erythema rather that white patches
Esophageal Candidiasis
ƒ
Usually coincides with CD4 count of < 50 /µl
ƒ
Causes substantial pain or a sense of obstruction on swallowing
ƒ
Most lesions occur on the distal third of the esophagus and appear on endoscopy as
redness, edema and focal white patches or ulcers
ƒ
If and HIV infected person has oral thrush and substernal pain up on
swallowing
presumed diagnosis of Esophageal Candidiasis can be made s
ƒ
Endoscopy would prove the diagnosis, but is unnecessary if the patient responds to
antifungal therapy
ƒ
Linear ulcerations of the esophagus may be seen on barium x-ray.
Treatment
Oral candidiasis
ƒ
Nystatin IU/ml suspension 2.5-5 ml gargled 5X daily
ƒ
2% Miconazole oral gel applied 2-3 x daily
ƒ
Amphotericin B lozenges
ƒ
Fluconazole 100mg –200mg PO /day for 7-14days in severe and persistent cases
ƒ
Oral hygiene, discontinue steroids and antibiotics if the patient is taking any
Esophageal Candidiasis
First line: Fluconazole 200mg/day PO (up to 400mg/day) for 14-21 days
Alternately
ƒ
Ketoconazole 200-400mg for 14-21 days
ƒ
Itraconazole 200mg/day for 14-21 days
Diarrhea in HIV positive patients
ƒ
Is a common clinical condition in HIV infected patients (>50%)
ƒ
May be acute or chronic , watery , mucoid or bloody
ƒ
May or may not be associated with fever
ƒ
Spectrum may depend on the degree of immunodeficiency state
ƒ
Pathogens may be: Bacterial, Viral, Protozoal, Fungal
,Metazoal , Others (malignancies)
111
,Spirochetal ,Mycobacterial