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home - Miscellaneous - Infection - GI AIDS Written by Dr Sebastian Zeki

GI AIDS

RUQP/fever/malaise Very raised ALP with normal bilirubin On ERCP - Papillary stenosis - Intrahepatic sclerosing cholangitis Causes -Cryptosporidium Microsporidia CMV MAC Cyclospora NHL Kaposi's Diagnosed by brush duodenal mucosa Cryptospordia (severe, most common) - swimming pools/lakes Microsporidia ("Merant inclusions") Giardia Viruses Causes: Pentamidine, DDI, DDC CMV, HSV, LAC, TB (needs pancreatic biopsy - difficult) Hepatic conditions: Granulomatous hepatitis. Micro/macro vesicular hepatosteatosis. Diffuse hepatocellular injury. Sclerosing cholangitis. Shigella Salmonella Campylobacter C. diff. CMV (in 40% in Wrights: only) Treat with Valganciclovir/Adofavir/Phoscarnet/Ganciclovir - Pathogen found in 50 to 85% of AIDS diarrhoea regardless of CD-4 - If shigella, salmonella or campylobacter nega-tive then for endoscopy. Cause: Bartonella - multiple liver cysts Treatment: Doxycycline/Erythromycin Clinical presentation: fever, weight loss, abdominal pain, reddish skin papules Viral: CMV/HSV (volcano crater ulcers)/EBV Fungal: histoplasmosis, cryptococcus Bacterial: MAI, TB, Nocardia, Actinomyces Tumours: NHL, Kaposi's, cancer, lymphoma Drugs: HAART Idiopathic With oesophageal problems give empirical candida treatment If doesn't resolve quickly then for OGD GI tract and AIDS AIDS cholangiopathy Biliary peliosis hepatitis (BPH) Enteritis: MCC Colitis Pancreatitis Oesophageal ulceration Written by Dr Sebastian Zeki

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