See Section 2.
Tuberculosis Typically a single swollen lymph node, most commonly in the cervical chain; may be generalized. Lymph nodes initially firm and small can become large and fluctuant. Suppuration with drainage and chronic fistulization may occur. Diagnosis can be confirmed on biopsy or aspirate.
Infected skin lesions lesions that are red, tender, warm, pustular, or crusty Abscess or folliculitis Most commonly caused by Staphococcus aureus. Incise and drain fluctuant abscesses with sterile technique. Treat for days or until resolved. Follow-up in days to confirm improvement.
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Impetigo Red, tender, warm papules, often with a honey-colored crust. Frequently on the face around the mouth , trunk, and groin of adults.https://www.hiphopenation.com/mu-plugins/italian/bukij-boston-dating.php
May appear as ulcerating lesions. Other lesions Eczema, psoriasis, contact dermatitis, prurigo nodularis, and other lesions can mimic infection. See sections on eczema, psoriasis, contact dermatitis, and prurigo nodularis in this table. Generally do not require antibiotics unless superinfection is present. Cellulitis Skin is red and warm; patient may be systemically unwell with fever.
Severe soft tissue infection Rapidly progressing skin infection, may involve subcutaneous fascia, pyomyositis, systemic toxicity. May be life- or limb-threatening. If IV not available, start dicloxacillin and clindamycin orally. May need hospitalization and possibly specialist care or surgery. Skin conditions that present as blisters or vesicles Adverse drug reactions Some drug reactions can cause generalized blistering or small bumps. A peeling rash involving the eyes or mouth can represent a very serious drug reaction causing Stevens-Johnson syndrome.
Stop all medications. Administer oral antihistamines. If Stevens-Johnson syndrome is suspected, hospitalize for supportive care. If patient was on ABC, do not reintroduce may be fatal.
See Protocol 3. Contact dermatitis Typically limited to the area in contact with the causative agent. Herpes simplex Vesicles with an erythematous base. Usually oral, genital, or peri-rectal. Generally in clusters. May have a history of recurrence. Herpes zoster Vesicles with an erythematous base in a dermatomal distribution. Lesions in more than one dermatome or lesions in eye are considered to be disseminated or complicated disease. All patients with HIV should be treated with antiviral therapy regardless of timing of lesion onset.
Administer analgesia as required. Skin conditions that present as generalized or itching rashes Adverse drug reactions Generalized widespread red rash with small papules, usually on trunk. Blistering or a peeling rash involving the eyes or mouth can represent a very serious drug reaction leading to Stevens-Johnson syndrome. Eosinophilic folliculitis Itchy papules and pustules most commonly on the head, trunk, and upper part of extremities.
Difficult to differentiate from infective follicultis; a biopsy will reveal eosinophilic infiltrate in the follicular epithelium. May occur with immune reconstitution. Usually resolves once ART is initiated. Permethrin cream and topical steroid creams can help; antihistamines for pruritis.
Scabies also head and body lice Rash and excoriations on the torso. Burrows can often be seen in the web space between the fingers and on the wrist.
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The face is usually not affected. Itching can persist for two weeks after treatment. Wash hair if involved. Leave on for hours, then wash. Repeat in one week. Seizures can occur from coverage of broad areas. Do not use in children or pregnant women. Trim fingernails, wash clothes and bedding.
Norwegian scabies Scabies crustosta Usually in advanced immunosupression CD4 6 months. If never treated in the past, treat with multidrug therapy per WHO guidelines. Occurs weeks after initiating treatment. No treatment necessary. Molluscum conta-giosum Pearly white or flesh-colored papules with central umbilication; most common on the face and genitals. Diagnosis is usually made by clinical appearance. Usually no treatment needed.
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Lesions will disappear in patients responding to ART. Psoriasis Thick, red, scaling patches with distinct margins. Often on elbows, knees, scalp, hairline, and lower back. May be itchy. Warts human papilloma virus Flesh-colored papules or raised areas of skin; common in genital or perianal area.
Topical treatment with cryotherapy or topical podofilox 0. Lesions of the mucous membranes Angular cheilitis Sores at the corners of the mouth. Most often caused by candidiasis but can also be present with malnutrition and vitamin B deficiency. Can become necrotizing and cause loss of teeth. If necrotizing, may need dental consultation for debridement and teeth extraction.
Oral hairy leukopenia Whitish or grayish, feathery, irregular-appearing lesions, usually at base of tongue or gums. Usually improves or resolves with ART. Thrush candida White plaques on an inflamed base on tongue, palate, buccal mucosa, or oropharynx. Sources: Bartlett JG. Puede resolverse con TAR. Linfoma Mayor riesgo en pacientes con VIH. Por lo general en cavidades corporales o SNC.
Puede presentarse fiebre.
Deben descartarse tanto el absceso como el linfoma. Por lo general se soluciona o mejora con TAR. Por lo general en el rostro alrededor de la boca , pecho e ingle de los adultos. Es contagioso. Puede presentarse como lesiones ulcerativas. Ver secciones sobre eccema, psoriasis, dermatitis de contacto y prurigo nodularis en esta tabla.
Puede representar un peligro para la vida o para las extremidades. Dejar de administrar todo tipo de medicamento. Si el paciente se encontraba tomando ABC, no reintroducir puede ser fatal. Ver Protocolo 3. Por lo general es oral, genital, o perirrectal y se presenta en grupos.