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! style="background: #4479BA; color:#FFF;  width: 350px;" | Disease
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! style="background: #4479BA; color:#FFF; width: 350px;" | Description
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! style="background: #4479BA; color:#FFF;  width: 350px;" | Clinical Findings
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! style="background: #4479BA; color:#FFF; width: 350px;" | Diagnosis
! style="background: #4479BA; color:#FFF;  width: 350px;" | Prophylaxis
! style="background: #4479BA; color:#FFF; width: 350px;" | Treatment
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Pneumocystis pneumonia|Pneumocystis Pneumonia]]
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*Caused by the fungus ''Pneumocystis jirovecii''.
*90% of cases occurred among patients with CD4+ <200
*Incidence among HIV patients: 2-3 cases per 100 person-year
| style="padding: 5px 5px; background: #F5F5F5;" |Subacute onset of progressive dyspnea, fever, nonproductive cough, and chest discomfort that worsens within days to weeks. Tachypnea, tachycardia, and diffuse dry rales are found in the physical examination.  
| style="padding: 5px 5px; background: #F5F5F5;" | Clinical presentation, blood tests, or chest x-rays are not pathognomonic for PCP.
| style="padding: 5px 5px; background: #F5F5F5;" | Start TMP-SMX prophylaxis when CD4+ <200 cells/µL or history of oropharyngeal candidiasis.  <br> Discontinue prophylaxis when  CD4+ is >200 cells/µL for >3 month.
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*TMP-SMX
*<small>Administer adjunctive corticosteroids in patients with pO2 <70 mm Hg or arterial-alveolar O2 gradient >35 mm Hg</small>
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Toxoplasma gondii]] Encephalitis
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* Caused by the protozoan ''Toxoplasma gondii''
* The greatest risk of disease occurs among patients with a CD4+ <50 cells/µL
* Primary infection occurs after eating undercooked meat containing tissue cysts or ingesting oocysts that have been shed in cat feces and have sporulated in the environment
| style="padding: 5px 5px; background: #F5F5F5;" | Focal encephalitis with headache, confusion, or motor weakness and fever
| style="padding: 5px 5px; background: #F5F5F5;" | Diagnosis is done with IgG antibodies.  CT scan or MRI of the brain will typically show multiple contrast-enhancing lesions, often with associated edema.  Definite diagnosis requires a brain biopsy.
| style="padding: 5px 5px; background: #F5F5F5;" |Start TMP-SMX prophylaxis when CD4+ <100 cells/µL <br> Discontinue prophylaxis when  CD4+ is >200 cells/µL for >3 month.
| style="padding: 5px 5px; background: #F5F5F5;" | Administer:
* [[Pyrimethamine]], PLUS 
* [[Sulfadiazine]], PLUS
* [[Leucovorin]]
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Cryptosporidiosis
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Microsporidiosis
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Mycobacterium tuberculosis
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| style="padding: 5px 5px; background: #F5F5F5;" colspan=5| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents <ref>{{cite web| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5804a1.htm| title=Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents}} </ref>
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Latest revision as of 20:23, 6 January 2015