CNS infections in HIV patients: Difference between revisions
From IDWiki
(→) |
(→) |
||
| Line 1: | Line 1: | ||
== Differential Diagnosis == |
== Differential Diagnosis == |
||
| + | * Idiopathic (up to 50%) |
||
| + | * HIV encephalitis |
||
| + | * Acute HIV |
||
* Infectious |
* Infectious |
||
| − | ** 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]] |
| − | ** Bacterial: [[syphilis]] |
+ | ** Bacterial: [[syphilis]] (common), [[Streptococcus pneumonia]], [[Mycoplasma]] |
| − | ** Fungal: [[cryptococcosis]], [[histoplasmosis]], [[blastomycosis]], [[coccidiomycosis]] |
+ | ** Fungal: [[cryptococcosis]] (most common cause of meningitis), [[histoplasmosis]], [[blastomycosis]], [[coccidiomycosis]] |
** Mycobacterial: [[tuberculous meningitis]] |
** Mycobacterial: [[tuberculous meningitis]] |
||
| − | ** Parasitic: [[ |
+ | ** Parasitic: [[toxoplasmosis]], [[neurocysticercosis]] |
* Non-infectious |
* Non-infectious |
||
** [[Primary CNS lymphoma]] |
** [[Primary CNS lymphoma]] |
||
| Line 17: | Line 20: | ||
** Cryptococcus antigen lateral flow assay |
** Cryptococcus antigen lateral flow assay |
||
** Acid-fast staining and tuberculosis culture |
** Acid-fast staining and tuberculosis culture |
||
| − | ** Fungal culture? |
+ | ** Fungal culture? PCR for JC virus, EBV? |
** Cytology and flow cytometry |
** Cytology and flow cytometry |
||
* MRI brain |
* MRI brain |
||
Revision as of 10:13, 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
