CNS infections in HIV patients: Difference between revisions
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== Differential Diagnosis == |
== Differential Diagnosis == |
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* Idiopathic (up to 50%) |
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* HIV encephalitis |
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* Acute HIV |
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* Infectious |
* Infectious |
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** Viral: routine viral causes of meningitis and encephalitits, [[JC virus]] |
** Viral: routine viral causes of meningitis and encephalitits, VZV (common), [[JC virus]], [[West Nile virus]], [[EBV]] |
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** Bacterial: [[syphilis]] |
** Bacterial: [[syphilis]] (common), [[Streptococcus pneumonia]], [[Mycoplasma]] |
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** Fungal: [[cryptococcosis]], [[histoplasmosis]], [[blastomycosis]], [[coccidiomycosis]] |
** Fungal: [[cryptococcosis]] (most common cause of meningitis), [[histoplasmosis]], [[blastomycosis]], [[coccidiomycosis]] |
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** Mycobacterial: [[tuberculous meningitis]] |
** Mycobacterial: [[tuberculous meningitis]] |
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** Parasitic: [[ |
** Parasitic: [[toxoplasmosis]], [[neurocysticercosis]] |
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* Non-infectious |
* Non-infectious |
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** [[Primary CNS lymphoma]] |
** [[Primary CNS lymphoma]] |
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** Cryptococcus antigen lateral flow assay |
** Cryptococcus antigen lateral flow assay |
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** Acid-fast staining and tuberculosis culture |
** Acid-fast staining and tuberculosis culture |
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** Fungal culture? |
** Fungal culture? PCR for JC virus, EBV? |
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** Cytology and flow cytometry |
** Cytology and flow cytometry |
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* MRI brain |
* MRI brain |
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Revision as of 14:13, 2 September 2021
Differential Diagnosis
- Idiopathic (up to 50%)
- HIV encephalitis
- Acute HIV
- Infectious
- Viral: routine viral causes of meningitis and encephalitits, VZV (common), JC virus, West Nile virus, EBV
- Bacterial: syphilis (common), Streptococcus pneumonia, Mycoplasma
- Fungal: cryptococcosis (most common cause of meningitis), histoplasmosis, blastomycosis, coccidiomycosis
- Mycobacterial: tuberculous meningitis
- Parasitic: toxoplasmosis, neurocysticercosis
- Non-infectious
Investigations
- Lumbar puncture with opening pressure and CSF sent for:
- Cell count and differential, protein, glucose
- Gram stain and bacterial culture
- Cryptococcus antigen lateral flow assay
- Acid-fast staining and tuberculosis culture
- Fungal culture? PCR for JC virus, EBV?
- Cytology and flow cytometry
- MRI brain
