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Referral Chart
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REFERRAL CHART

Here's a table of common opportunistic infections.

The causative bug is... The type of bug it is... Affecting these body parts... With such symptoms as... And may need to be diagnosed by... And may be treated by such drugs as... Other comments
Pneumocystitis carinii (PCP) Fungus Lungs (pneumonia), possibly other Cough, fever, shortness of breath (dyspnea) Chest X-ray, sputum, Bronchoscopy (BAL) TMP-SMX=Bactrim=, Septa, Pentamedine, trimetrexate Recurrence markedly decreased with prophylaxis
Kaposi's sarcoma Not a bug; more like tumor Skin and many internal organs (lungs, liver, brain, gut) None at all, or dyspnea, abdominal pain, visible lesions Skin biopsy, multiple other organ biopsies Radiotherapy, chemo, interferon, intralesional injection, none New evidence shows growth factor causes KS, may lead to new Rx
Cytomegalovirus (CMV) Virus Retinitis (eyes), lungs (pneumonia), gut (colitis), brain Blindness, dyspnea, ulcers, diarrhea, confusion, fevers Cultures from blood, urine, sputum, feces DHPG=Ganciclovir usually gives remission then maintenance Oral DHPG being developed
Candida albicans Fungus Mouth (thrush), esophagus, gut, anus Loss of taste and appetite, dry mouth Smear, endoscopy, visible exam for thrush (no test) Nystatin (Mycostatin), clotrimazole (Mycalex), ketoconazole (Nizoral) Thrush alone not diagnostic of AIDS
Mycobacterium avium; Intracellulare MAI, MAC, M. avium Mycobacterium Lungs, bone marrow, liver, intestine, brain, skin Severe fever/chill, bone and abdominal pain, weight loss, weakness Cultures from blood or bone marrow No truly effective: rifampin, ethambutol, ciprofloxacin, streptomycin "Cousin" to real TB, but not contagious, i.e. is opportunistic
Mycobacterium tuberculosis (real TB) Mycobacterium Lungs, bone marrow, liver, intestine, brain Same as above, cough & marked weight loss (consumption) Sputum tests, skin tests, cultures, X-rays Very effective INH + rifampin + ethambutol By itself in lungs, not AIDS diagnostic, not opportunistic, MAI often confused
Cryptococcus neoformans ("Crypto") Fungus Brain (meningitis), bloodstream, lungs Headache, fever, confusion (may be no stiff neck) Spinal tap = lumbar puncture = LP, blood antigen level Amphotericin B +5-flucytosine; now also fluconazole Lifelong maintenance needed, much easier with fluconazole (pill)
Toxoplasms gondii ("Toxo") Protozoan Brain (encephalitis), eyes (retinitis) Confusion, seizures, "stroke", visual changes CAT scan and/or MRI, blood titer Sulfadiazine + pyrimethamine Lifelong maintenance TMP-SMX, PCP prophylaxis may also work
Cryptosporidium or Isospora Belli Protozoan GI tract (colon) Diarrhea Stool sample Lomotil or imodium to help diarrhea but no real cure for bug Experimental Rx for Crypto: somatostatin bovine immune glob. TMP-SMX for Isospora< tr>
Herpes simplex Virus Mouth; brain (encephalitis), skin, lungs Pain, skin lesions, confusion Smear/culture of lesions Acyclovir=Zovirax (cream, pills, or IV), vidarabine if brain Healthy immune also can get lesions, thus not truly opportunistic
AIDS Dementia Complex Not an infection (probably) Brain Loss of memory, affects coordination CAT scan and/or MRI AZT (efficacy not definitely shown) Diagnostic of AIDS even if no concurrent infection

 

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