Match each clinical presentation of an opportunistic infection in a patient with advanced HIV to its most appropriate first-line targeted antimicrobial therapy.
- A patient with a CD4 count of 180 cells/mm³ presents with a 3-week history of progressively worsening dyspnea, dry cough, and bilateral interstitial infiltrates on chest radiograph.Trimethoprim-sulfamethoxazole
- A patient with a CD4 count of 80 cells/mm³ presents with a progressive headache, fever, and elevated opening pressure on lumbar puncture; cerebrospinal fluid India ink stain is positive for encapsulated yeast.Amphotericin B and flucytosine
- A patient with a CD4 count of 40 cells/mm³ presents with unilateral floaters, flashes of light, and decreased visual acuity; fundoscopy reveals yellow-white retinal exudates with perivascular hemorrhage.Valganciclovir
- A patient with a CD4 count of 70 cells/mm³ presents with a new-onset generalized seizure and focal weakness; brain MRI demonstrates multiple ring-enhancing lesions in the basal ganglia.Sulfadiazine, pyrimethamine, and leucovorin
Cevap
Pneumocystis pneumonia is treated with trimethoprim-sulfamethoxazole; Cryptococcal meningitis with amphotericin B and flucytosine; CMV retinitis with valganciclovir; and Toxoplasma encephalitis with sulfadiazine, pyrimethamine, and leucovorin.
Each opportunistic infection has a distinct clinical presentation linked to specific CD4 count thresholds and requires a corresponding optimal, evidence-based antimicrobial regimen.
Adım Adım Çözüm
Anahtar Kavram
First-line treatment of opportunistic infections in HIV patients based on clinical presentation and CD4 count.