Correlate the following clinical presentations of central nervous system and disseminated infections in immunocompromised hosts with their most appropriate primary targeted management.
- A patient with untreated HIV and elevated opening pressure on lumbar puncture; cerebrospinal fluid reveals budding yeast with a thick polysaccharide capsule.Induction therapy with intravenous liposomal amphotericin B and oral flucytosine
- A solid organ transplant recipient with a new ring-enhancing brain mass and cavitary pulmonary lesions; aspirate reveals branching, weakly acid-fast filamentous bacteria.Intravenous trimethoprim-sulfamethoxazole
- A patient with advanced HIV (CD4 count 45 cells/mm³) presenting with seizures; MRI reveals multiple basilar ring-enhancing lesions with surrounding edema.Oral pyrimethamine, sulfadiazine, and leucovorin
- A patient with profound neutropenia undergoing leukemia induction chemotherapy who develops facial pain and a rapidly expanding necrotic eschar on the hard palate.Urgent surgical debridement and intravenous liposomal amphotericin B
- A patient with AIDS presenting with progressive cognitive decline and ataxia; MRI shows asymmetric, non-enhancing white matter lesions without mass effect.Initiation and optimization of combination antiretroviral therapy
Cevap
The correct pairings appropriately match the unique microbiological and radiographic findings of opportunistic infections with their definitive standard-of-care therapies.
Each correct pairing accurately identifies the opportunistic pathogen from its characteristic diagnostic clues and assigns the current guideline-directed first-line therapy.
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Anahtar Kavram
Management of central nervous system and disseminated opportunistic infections in immunocompromised hosts
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