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HIV/AIDS, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • AIDS: Defined as lab evidence of HIV with CD4 <200 or AIDS defining illness—infection (e.g., cryptosporidium), malignancy (e.g., Kaposi, cervical cancer), or other (e.g., HIV wast...

Diagnosis

Signs and Symptoms

  • Primary HIV infection: 2–6 wk after exposure:

    • Fever and malaise

    • Rash on face and trunk

    • Flu-like syndrome with lymphadenopathy and hepatosplenomegaly

    • Pharyngitis

    • Diarrhea

    • Up to 90...

Treatment

Ed Treatment/Procedures

  • Patients who appear to have bacterial infections, appear toxic, or have rapidly progressive symptoms should receive their 1st dose of antibiotics in the ED.

  • Begin HIV t...

Follow-Up

Disposition

Admission Criteria

  • Unexplained fever with CNS involvement or suspected endocarditis

  • Neutropenic fever

  • Hypoxemia (PaO2 <70 mm Hg)

  • Cardiac symptoms suggestive of ACS

  • Pericardial effus...

Pearls and Pitfalls

  • Immune reconstitution inflammatory syndrome usually manifests within 8 wk of initiation of HAART as symptoms of opportunistic or autoimmune disease.

  • For occupation exposures, there ...

Additional Reading

  • Belleza  WG, Browne  B. Pulmonary considerations in the immunocompromised patient. Emerg Med Clin North Am.  2003;21(2):499–531.

  • Church  JA. Pediatric HIV in the emergency depar...

Codes

ICD9

  • 042 Human immunodeficiency virus [HIV] disease

  • V08 Asymptomatic human immunodeficiency virus [HIV] infection status

  • 007.4 Cryptosporidiosis

  • 176.9 Kaposi's sarcoma, unspecified site

  • 007.8 Other s...

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