Fever in an HIV patient

Background

• Fever of unknown origin in this population includes temperatures >38.3ºC without diagnosis over 4 weeks (outpatient) or 3 days (inpatient) in patients with HIV, despite initial investigations including preliminary results of blood cultures at 48 hours

Differential Diagnosis

• Routine infections: pneumonia, bacteremia
• Opportunistic infections
  • Disseminated Mycobacterium avium complex (most common cause in one US study)
  • Pneumocystis jirovecii
  • CMV disease
  • Tuberculosis
  • Histoplasmosis, cryptococcosis
  • Toxoplasmosis
• Non-infectious causes
  • HLH
  • Non-Hodgkin lymphoma