Gastrointestinal disease in HIV-AIDS Exhibition

Gastrointestinal diseases, especially diarrhea, are a major problem for patients with HIV. Salmonella can be a persistent problem, especially in patients with blood or mucus in the stool. Severe and prolonged diarrhea in pediatric patients with AIDS also occurs with parasitic enteric pathogens, particularly Glardia lamblia and Cryptosporidium. In some cases, even after extensive evaluation, no specific etiology can be found to explain the diarrhea.

Clinical evaluationand ancillary data
Using an aggressive diagnostic approach, because many acute illnesses are treatable. For example, a child with HIV infection presented with fever is most likely a bacterial infection: obtaining a complete blood count (CBC), blood culture, urinalysis and chest X-ray if there is no obvious source of foot examination, imaging studies, such as movies of the breast may be indicated. If your child has a history of neutrophils may be depressed, whichinfluence treatment decisions. The new onset of pulmonary symptoms requires a thorough evaluation. Although many of these patients can not easily curable lung disease, early treatment is important because it is difficult to distinguish clinically common forms of pneumonia in children, AIDS, hospitalization is often required. In these patients, initial diagnostic tests include chest radiograph, white blood cell count, blood culture, and in the appropriate epidemiologicalestablishment, nasopharyngeal specimens by immunofluorescence or culture.

Weight loss and diarrhea may be acute or chronic and are often very serious. In addition to routine bacterial culture, stool for ova and parasites obtained. Assess the hydration status of the patient clinically and measure serum electrolytes, urea and creatinine, as the great loss of fluid and electrolyte imbalances are sometimes present deep. CNS symptoms and physical signs to determinelumbar puncture, or if the analysis is appropriate. If lumbar puncture is performed for more fluid than is necessary for the diagnosis of bacterial meningitis, and other tests are often referred to as a culture of acid-organisms, viral culture and cryptococcal antigen. If focal neurologic signs are present, to schedule a CT scan to evaluate lymphoma or toxoplasmosis.

Treatment and disposal
The treatment plan and the decision to hospitalize a patient should be madein collaboration with the family, many families want aggressive diagnostic and therapeutic plan, while others prefer to maintain limited medical intervention, in order to make the patient comfortable.

Consider hospitalizing patients with HIV infection with fever without focus of infection, the recent emergence of the lung or CNS manifestations, or failure to thrive or diarrhea. Patients who are severely ill and require hospitalization may require antibiotic treatment.If a source of infection is seen, for example, the media, sinusitis or otitis, and no evidence of bacteremia, the patient can be managed and patients. However, a longer duration of therapy is necessary, for example, treatment of sinusitis for at least 3 weeks.

In the case of suspected bacteremia, antibiotics should be effective against encapsulated organisms and enteric gram-negative. For each patient with HIV who do not require that the main problemReferences to medical management and long term. Due to the complex and chronic nature of pediatric HIV infection, non-urgent problems are best handled in the Pacific, based in the family or in an outpatient clinic, not the emergency department. Isolation techniques are based on the mode of transmission of the disease.