Oral Cavity Lesions in a patient with HIV/AIDS White plaque

Blurry vision in a patient with HIV/AIDS Anterior Segment: • Herpes zoster ophthalmicus • Keratitis (HSV, Staph, Moraxella, Pseudomonas, Acanthameoba, Candida, other fungi) • Uveitis (Syphilis, HSV, VZV, TB*, Histo*, Cocci*, Toxo*, non-infectious including rifabutin) Posterior Segment: • HIV retinopathy* • CMV retinitis* • Ocular Toxo / Toxo retinitis* • Acute retinal necrosis (ARN) (VZV >HSV, CMV) • Progressive Outer Retinal Necrosis (PORN*) (VZV > HSV, CMV) • Choroidal infections (crypto, PJP, syphilis) *Most Often seen with lower CD4 cell count Dr. Darcy Wooten @Darcy_ID_doc #Blurry #vision #HIVAIDS #InfectiousDiseases #Anterior #Posterior #Differential #Diagnosis #Schema

Classification of oral lesions in transplant patients Infectious: • HSV infection • VZV virus infection • Epstein-Barr viruses • CMV infection • Bacterial infections including dentoalveolar abscesses, dental caries • Candidiasis • Deep fungal infections: Aspergillosis, Cryptococcosis, Mucormycosis, Blastomycosis Noninfectious: • Neoplasms • Lymphoma • Kaposi's sarcoma • Graft versus host disease • Oral mucositis • Salivary gland dysfunction • Developmental tooth defects #oral #lesions #transplant #mouth #diagnosis #differential

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

Oral / Mouth Lesions and Ulcers (Adult & Elderly) - Differential Diagnosis Algorithm Teeth • GERD (Dissolves enamel) • Sjögren's Syndrome (Dental Caries) Ulcerating Gastrointestinal • Crohn's Disease • Ulcerative Colitis • NSAlDs Ulcerating Other • Canker Sore • Cold Sore • Anemia • Langerhan's Cell Histiocytosis • Granulomatosis with polyangiitis (GPA)/microscopic polyangiitis (MPA) • Sarcoidosis • Drug Induced • Sexually Transmitted Infection Non-Ulcerating Lighter / White • Candidiasis • Lichen Planus • Anemia • Leukoplakia • Squamous Cell Carcinoma Non-Ulcerating - Darker (Red) • Gingivitis • Kawasaki Disease (Strawberry Tongue) • Other Gum Disease • Mucocele • Allergic Reaction Non-Ulcerating - No Colour Change • Chronic Liver Disease • Sjögren's Syndrome • Acromegaly • Amyloidosis • Psoriasis • Gingival Hyperplasia • Dry Mouth #Oral #Mouth #Disorders #Ulcers #Ulcerating #Differential #Diagnosis #Algorithm #Causes

Causes of Knee Effusions - Differential Diagnosis Framework Knee Effusion Red Flags: 1. Fever/Chills/Joint pain/Night sweats/Weight loss - DDX: - Infection - Systemic disease - Malignancy 2. Non-weight bearing after injury 3. Loss of signal pulses 4. Loss of sensation distal to the knee Infectious Knee Effusions - Septic Arthritis: - Staphylococcal (40%) - Streptococcal (28%) - Gm - bacilli (19%) - Mycobacterium (8%) - Gm - cocci (3%) - Gram + bacilli (1%) - Anaerobes (1%) - Watch out for: - Gonorrhea - Lyme’s disease - Syphilis - Tuberculosis - Brucellosis - Viruses: HIV, Chikungunya - Herpes virus: CMV, HSV, Varicella, EBV - Parvovirus - Hepatitis B, C - Rubella - Alphavirus - Fungi: Sporotrichosis, Coccidiomycosis, Candidiasis Inflammatory Knee Effusions: - Gout - Pseudo gout - Osteoarthritis - Overuse syndrome - Spondyloarthritis: - Reactive arthritis - Inflammatory bowel disease - Rheumatoid arthritis - Juvenile RA/Idiopathic arthritis - SLE - Behcet Disease Post-Infectious Knee Effusions: - Seronegative Reactive Syndrome - Acute rheumatic fever - Poststreptococcal reactive arthritis Traumatic Knee Effusions: - Ligamentous injuries - Meniscal injury - Intra-articulation fracture - Patellar dislocation Malignant Knee Effusions: - Hematologic - Leukemia - Ewing’s sarcoma - Giant cell tumor - Osteosarcoma - Eosinophils granuloma - Synovial sarcoma - Chondroblastoma - Benign Tumors: - Aneurysmal bone cyst - Osteochondroma Hematologic Knee Effusions: - Hemarthrosis - Hemophilia - Synovium - Oral anticoagulant therapy - Sickle cell disease Dr. Ravi Singh @rav7ks #Knee #Effusions #causes #differential #diagnosis #msk #physicalexam