USMLE Forum Archives - USMLE Step 3 - Natural Hx of HIV complications in child
Natural Hx of HIV complications in child
zkadhem - 05-15-09 11:37
-Twenty-five percent of children with HIV infection demonstrate some cognitive and motor deficits.
- They face problems with verbal expression, attention deficits, hyperactivity, & hyper-reflexia.
- Lymphocytic interstitial pneumonitis (LIP) is characterized by diffuse reticulonodular infiltrates and hilar lymphadenopathy and occurs in up to 40% of children with perinatally acquired HIV. LIP is very rare in adults.
- Kaposi’s sarcoma is associated with a herpes virus infection and is very rare in children.
- Toxoplasmosis, usually presenting as focal mass brain lesions, is a reactivation of previous infection, and is therefore also very rare in children.
- Hepatobiliary complications are more common in adults than in children, but the reason for this is unclear.
- PCP in children has a peak onset at 3–6 months of age and often carries a poor prognosis. TMP-SMX is still the first-line agent and can be safely started at 4 weeks. If this drug is not tolerated, dapsone or aerosolized pentamidine are acceptable alternatives. Remember that CD4 counts in children are naturally higher, starting at 1,500/mm3 in infants and decreasing to adult levels by age 6. Due to the naive nature of young children’s immune systems, PCP can occur in infants despite a “normal” CD4 count.
zkadhem - 05-15-09 11:37
-Twenty-five percent of children with HIV infection demonstrate some cognitive and motor deficits.
- They face problems with verbal expression, attention deficits, hyperactivity, & hyper-reflexia.
- Lymphocytic interstitial pneumonitis (LIP) is characterized by diffuse reticulonodular infiltrates and hilar lymphadenopathy and occurs in up to 40% of children with perinatally acquired HIV. LIP is very rare in adults.
- Kaposi’s sarcoma is associated with a herpes virus infection and is very rare in children.
- Toxoplasmosis, usually presenting as focal mass brain lesions, is a reactivation of previous infection, and is therefore also very rare in children.
- Hepatobiliary complications are more common in adults than in children, but the reason for this is unclear.
- PCP in children has a peak onset at 3–6 months of age and often carries a poor prognosis. TMP-SMX is still the first-line agent and can be safely started at 4 weeks. If this drug is not tolerated, dapsone or aerosolized pentamidine are acceptable alternatives. Remember that CD4 counts in children are naturally higher, starting at 1,500/mm3 in infants and decreasing to adult levels by age 6. Due to the naive nature of young children’s immune systems, PCP can occur in infants despite a “normal” CD4 count.
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Re: Natural Hx of HIV complications in c meduploader - 05-15-09 14:03 HIV is very HY topic for step 3.
These concepts are tested heavily and it is nice to having them all under appropriate headings.
Thanx for ur hard work, and appreciate ur sharing.
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