Pulmonary Infections in HIV-AIDS Bacterial: • No organism identified, Strep pneumoniae, H. influenzae, S.aureus, Streptococcus Grp B, P.aeruginosa, S.anginosus, Moraxella catarrhalis, Enterobacterales, Legionella spp, Atypical infection (Mycoplasma pneumoniae, Chlamydophila pneumoniae), Rhodococcus equi, Bordetella pertussis, Nocardia asteroides Viral: • CD4 > 200: Influenza, Adenovirus, RSV, Parainfluenza • CD4 < 200: CMV, HSV Mycobacterial: • CD4 > 200: M.tuberculosis • CD4 < 200: M.tuberculosis, NTM (M.kansasii, MAC) Fungal: • CD4 > 200: Endemic fungi (Coccidioides) • CD4 < 200: PCP, Aspergillus spp, Endemic fungi (Histoplasma, Cryptococcus, Coccidioides), Penicillium marneffei Parasitic: • CD4 < 200 (Rarely): Toxoplasma gondii (CD4<50), Strongyloides stercoralis, Cryptosporidium parvum, Microsporidum Non-infectious: • CD4 > 200: Pulm embolism, Pulm edema, heart failure, COPD, Lung cancer, Primary pulm HTN, Lymphocytic or lymphoid interstitial pneumonitis, Abacavir hypersensitivity • CD4 < 200: Pulmonary Kaposi's Sarcoma, Lymphoma (Non-Hodgkin's in particular) Evaluation: Imaging (CXR +/- High res CT chest scan), CBC/diff, Blood and sputum cx (Bacterial, Fungal, AFB), TB PCR sputum, PCP DFA sputum, LDH, ABG, BDG, Serum Cryptococcal Ag, Urine Histo Ag, Respiratory viral panel, Consideration of early bronchoscopy Infectious Diseases Fellows Network @ID_fellows #Pulmonary #Infections #HIVAIDS #workup #diagnosis #evaluation #differential #CD4
