Second Chance - Opportunistic Infections

What is the CD4 cell count threshold for Oral Candidiasis?

< 200 cells

< 100 cells

What drug and dose should be used to treat thrush?

Fluconazole 100mg QD x 7 days (14days for esophageal)

Fluconazole 200mg BID x 7 days (14days for esophageal)

Is PPX required if below CD4 cell threshold for oral candidiasis?

No - only when painless, creamy-white plaque-like lesions present

Yes, PPX to prevent occurrence of thrush

Treshold for pneumocystis jirovecii pneumonia?

CD4 cell count <200

CD4 cell count <100

What drug should be used to treat PJP, and what dose? Assume no allergies

Bactrim 15mg/kg/day of TMP + 5x SMP DAILY

Dapsone 100mg PO daily

Atovaquone suspension 1500mg PO daily

What drug should be used to treat PJP, and what dose? Assume sulfa allergy

Bactrim 15mg/kg/day of TMP + 5x SMP DAILY

Dapsone 100mg PO daily

Atovaquone suspension 1500mg PO daily

What drug should be used to treat PJP, and what dose? Assume intolerant to 1st and 2nd line tx

Bactrim 15mg/kg/day of TMP + 5x SMP q6 or 8 hours

Dapsone 100mg PO daily

Atovaquone suspension 1500mg PO daily

Mod-Severe tx of PJP?

PO2 < 70 mm Hg OR AA O2 gradient > 35 mm Hg

Bactrim IV WB dosing x 21 days

Prednisone taper, 40mg BID x5d, 40mg QD x5d, 20mg QD x 10d

How long should PJP be treated for?

Until CD4 cell count > 200 for 3 mo

What test needs to be performed before using Dapsone, and why?

G6PD to avoid hemolytic anemia

Toxoplasmosis Gondii CD4 threshold to treat and d/c tx?

Treat when below <100 and toxo IgG (+)

D/C when above >200 cells for 3 months

PPX for toxoplasmosis gondii?

Bactrim 1 DS tablet daily

PPX for toxoplasmosis gondii if sulfa allergy?

Dapsone/pyremethamine/leucovorin

Sulfadiazine/pyremethanine/leucovrin if infected with toxo

Threshold for Mycobacterium avoid complex PPX?

CD4 Cell Count <50

Treat MAC until CD4 cell above what number?

CD4 Count > 100 for at least 3months

What can you use to PPX for MAC?

Azithromycin 1200mg PO once weekly

Side effect of high-dose azithromycin?

Diarrhea

Second Chance - Opportunistic Infections

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