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Appendix 6 MANAGEMENT OF HIV INFECTION IN CHILDREN Investigations for Opportunistic infections* Notes Investigation Specimen Opportunistic Infections Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), Staphylococcus aureus, or Escherichia coli Bacterial Pneumonia • Culture • Blood Zar HJ, Tannenbaum E, Hanslo D, Hussey G. Sputum induction as a diagnostic tool for community acquired pneumonia in infants and young children from a high HIV prevalence area. Pediatr Pulmonol 2003;36:58. • Gram Stain, Culture • Induced Sputum • Pleural Fluid • Bronchoalveolar Lavage (Bal) • Gram Stain • Culture And Sensitivity • Endotracheal Aspirate • Direct Immunofluorescence • Tzanck Smear • Culture • PCR • Skin, Conjunctiva, Or Mucosal Lesion Scrapings Herpes zoster 81 • KOH Preparation • Culture • Skin Scrapings • Biopsy Cutaneous fungal infections • KOH Preparation • Culture • Mucosal Scraping Oral esophageal candida Poor negative predictive value for sputum Bronchoscopy with BAL is the diagnostic procedure of choice for infants • Silver Stains • Monoclonal Immunofluorescent Antibodies • Induced Sputum • Bal • Endotracheal Aspirate • Lung Biopsy Pneumo jiroveci pneumonia(carinii)
Appendix 6 Investigations for Opportunistic infections* Notes Investigation Specimen Opportunistic Infections Alvarez F, Bandi V, Stager C, Guntupalli KK. Detection of Pneumocystis carinii in tracheal aspirates of intubated patients using calcofluor-white (Fungi-Fluor) and immunofluorescence antibody (Genetic Systems) stains. Crit Care Med. 1997 Jun;25(6):948-52. Search Pubmed endotracheal Suction Pneumocystis = 2 titles one relevant Pneumo jiroveci pneumonia(carinii) Histopathology shows alveoli filled with eosinophilic, acellular, proteinaceous material that contains cysts and trophozoites but few inflammatory cells • Histopathology • Lung Biopsy MANAGEMENT OF HIV INFECTION IN CHILDREN Two PCR commercial kits are available for rapid, direct detection of M. tuberculosis, and both are labeled for use on sputum only. One is labeled for use on sputum only with AFB detected on the smear. When these tests are used for other specimens, sensitivity and specificity might be unsatisfactory. • Histopatology • Biopsied Lung • Peripheral Lymph Node • Other Tissue Depending On Location Of Disease) Tuberculosis 82 Specimens should be cultured with radiometric culture methods and DNA probes for species identification. M. tuberculosis can be isolated and identified in 7--14 days. • Culture Conventional/ Automat • ZN Stain • PCR • Sputum • Induced Sputum • Gastric Lavage • BAL • Mycobacterial Culture • Blood • Direct microscopy • Culture • Skin lesions • Blood • Lymph nodes • Bone marrow Penicillium marneffei * Only the more common opportunistic infections are discussed
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This Guideline is intended a guide
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MANAGEMENT OF HIV INFECTION IN CHIL
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REVIEW COMMITTEE The draft guidelin
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TABLE OF CONTENTS MANAGEMENT OF HIV
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3.30 MB - Academy of Medicine of Malaysia

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