The EM Educator Series: HIV/AIDS + Fever

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!


Case 1:

A 41-year-old male with history of HIV and poor compliance with medical therapy presents with cough and progressive shortness of breath over several weeks. He noted fever the last several days. His vital signs include HR 114, RR 23, BP 100/56, T 38.1 C, and saturation 88% on room air. He appears toxic.

Case 2:

A 55-year-old female is brought in for altered mental status. She has a history of AIDS. According to her husband, she has not been eating or drinking at home and has demonstrated increasing confusion at home. She was diagnosed with and treated for PJP one year ago. On exam, her GCS is 8, and she is febrile.

 

Considerations:

  • How do HIV and AIDS differ?
  • What opportunistic infections are associated with specific CD4 counts?
  • How can you estimate the CD4 count if this is not available in patient history or records?
  • What sources should you consider in the patient with HIV/AIDS and fever?
  • How does PJP present, how should suspected PJP be evaluated and managed, and how do these patients decompensate?
  • How do cryptococcus and toxoplasmosis differ in patients with HIV/AIDS?
  • What abdominal complications can arise in HIV/AIDS patients?

 

Suggested Resources:

Check out this amazing illustration from @HansonsAnatomy

 

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