Cutaneous Cryptococcosis

Common HAART Side Effects

1. Indinavir: crystal-induced nephropathy
2. Didanosine: pancreatitis
3. NRTIs: Lactic acidosis
4. Nevirapine: Liver failure
5. NNRTIs: Steven-Johnson syndrome

Antibiotics

1. Semisynthetic penicillinase-resistant penicillins: Oxacillin, cloxacillin, dicloxacillin, nafcillin
when sensitive, better than vancomycin, also treat strep: s. pneumonia, Viridans, group A, B, C, G
MRSA: use vancomycin, or Linezolid, quinupristin/dalfopristin as alternatives

2. Penicillin G, penicillin VK, ampicillin, amoxcillin
strep + E. Coli + listeria + Neisseria

3. Piperacillin, ticarcillin, mezlocillin
Enterobacteriacceae + pseudomonas

4. Ceph for pseudomonas: Only ceftazidime and cefepime

5. Penicillin insensitive pheumococci: cefatriaxone & cefataxime

6. Quinolones for pseudomonas: only ciprofloxacin

7. Exclusive Gram (-): gentamicin, tobramycin, amikacin, aztreonam

8. all: imipenem, meropenem, ertapenem(no pseudomonas)

9. Anaerobes: Metronidazole, clindamycin, carbapenem

Rashes

Anthrax

Endocarditis

Roth's spot



Splinter Hemorrhage


Osler's node with Janeway Lesion

Rocky Mountain Spotted Fever

Lyme disease

AIDS Opportunitistic Infection

PCP (CD4<200): first occuring opportunitistic disease

Dx: bronchoscopy with lavage
lab: increased LDH
Txt: TMP-SMZ, steroid if severe
Prophylaxis: TMP/SMZ, Dapsone, Atovaquane, Pentamidine, if CD4<200

Cryptococcosis (CD4<100)
meningitis
Dx: CSF: india ink + antigen test, lower CSF cell count --> worse
Txt: amphotericin + fluconazole
Prophylaxis: not recommended

Cytomegalovirus (CD4<50)

retinitis + colitis + esophagitis + encephalitis
Dx: fundoscopy of retinitis + endoscopic biopsies
Txt: Valganciclovir P.O., IV ganciclovir if sever, foscarnet and cidofovir if resistant
A.E.: ganciclovir --> neutropenia foscarnet and cidofovir --> renal toxicity


MAC (CD4<50)
fever + night sweats + bacteria + wasting + anemia + diarrhea
Dx: culture of blood, BM, and other tissues
Txt: clarithromycin + ethambutol
Prophylaxis: azithromycin, clarithromycin if CD4<100

Toxoplasmosis (CD4<50)
Brain mass lesion
Dx: CT or MRI contrast shows ring enhancing lesion, shrink after trial therapy
serology, CSF PCR
Txt: Pyrimethamine + sulfadiazine
Prophylaxis: TMP/SMZ