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Session 9 - PowerPoint Presentation

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Session 9 - PowerPoint Presentation Powered By Docstoc
					Managing Patients with HIV-
    Related Diseases


       Part A: Module A2
          Session 9



                           Part A/Module 2/Session 9
               Purpose


 To learn about fever including common etiologies,
  recommended diagnostics, common findings,
  management and treatment of bactermia/septicemia.




                                     Part A/Module 2/Session 9
                Objectives


 To describe the various etiologies that cause
  fever
 To describe the clinical presentation of
  bacteremia/septicemia
 To explain the recommended diagnostics and
  describe the common findings for these tests




                                        Part A/Module 2/Session 9
                                Objectives, continued



 To describe the management and treatment for
  bacteremia/septicemia.


 To make a differential diagnosis using a case
  study approach.




                                        Part A/Module 2/Session 9
                Overview


Fever:
         a recurrent or persistent elevation in
         temperature (>37.5 ºC) for a duration
         of more than 2 weeks as the only
         clinical presentation in a patient with
         HIV infection




                                         Part A/Module 2/Session 9
                      Fever

   Differential diagnosis Includes the following
    etiologies:
    •   Protozoal infection: Malaria
    •   Bacterial infection: Pyogenic infections of the
        chest, CNS, or urinary tract, etc.
    •   Bacteremia due to Borreliosis, Salmonella,
        Streptococcus pneumonia, H. influenzae, etc.
    •   Mycobacterial infection: Mycobacterium
        tuberculosis, atypical mycobacteria
    •   Viral infection: Upper respiratory tract
        infections, Cytomegalovirus, EBV, HIV infection
        itself
    •   Malignancies: Lymphomas

                                          Part A/Module 2/Session 9
         Bacteremia/Septicemia


   Common etiological agents: Pneumococcal,
    meningococcal

   Clinical presentation: fever (intermittent), chills
    at onset, pulse weak and rapid, skin eruptions
    (petechial or purpuric most common),
    headache, anorexia, vomiting diarrhea,
    delirium, shock, hypotension, vascular collapse,
    renal failure, death



                                         Part A/Module 2/Session 9
      Recommended Diagnostics


   Urinalysis for albumin, erythrocytes, leukocytes.
   Blood cultures for aerobic and anaerobic
    organisms
   Blood counts for anemia




                                          Part A/Module 2/Session 9
Common findings:
    Urine may be positive for albumin, etc.
   Blood cultures may be positive
   Patient may be anemic
Management and treatment:
    Amoxicillin and gentamycin or ciprofloxacin.
    Supportive measures: adequate nutrition and fluid
     intake; maintain electrolyte balance with IV fluids
Comments: requires vigorous treatment, including
      hospitalization


                                        Part A/Module 2/Session 9

				
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