AIDS fever of unknown origin

Background

• Sources of fever vary by stage of disease:
  • CD4 >500
    • Work-up similarly to nonimmunocompromised pts
  • CD4 200-500
    • Early bacterial respiratory infection most common
  • CD4 <200
    • PCP, central line infection, MAC, TB, CMV, drug fever, sinusitis
    • Also consider: endocarditis, lymphoma, histo, crypto
  • CD4 <100
    • Also consider disseminated MAC

Workup

1. CBC
2. Chemistry
3. LFT
4. RPR
5. UA/Cx
6. Blood cx
   1. Aerobic, anaerobic, fungal
7. Crypto
8. Toxo
9. Coccidiodomycosis
10. CXR
11. Stool cx / O&P
12. CT
13. LP
    1. Cell count, protein, glucose, VDRL, cryptocoocal antigen, cytology, toxo, CMV, JC, EBV

See Also

HIV - AIDS (Main)

Source

Tintinalli