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]] |
| − | ** 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]] |
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| − | ** Parasitic: [[ |
+ | ** Parasitic: [[toxoplasmosis]], [[neurocysticercosis]] |
* Non-infectious |
* Non-infectious |
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** [[Primary CNS lymphoma]] |
** [[Primary CNS lymphoma]] |
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== Investigations == |
== Investigations == |
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| − | * CSF sent for: |
+ | * Lumbar puncture with opening pressure and CSF sent for: |
** Cell count and differential, protein, glucose |
** Cell count and differential, protein, glucose |
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** Gram stain and bacterial culture |
** Gram stain and bacterial culture |
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| − | ** Cryptococcus antigen lateral flow assay |
+ | ** [[Cryptococcus]] antigen lateral flow assay |
** 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? |
** Cytology and flow cytometry |
** Cytology and flow cytometry |
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* MRI brain |
* MRI brain |
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| + | [[Category:HIV]] |
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| + | [[Category:CNS infections]] |
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Latest revision as of 10:46, 17 February 2022
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
