Clinical Manual for Management of the HIV-Infected ... - myCME.com

Treatment
Once the diagnosis is made, appropriate treatment
should be initiated. In seriously ill patients, presumptive
treatment may be started while diagnostic test results
are pending. See the appropriate chapter in Section 6:
Disease-Specific Treatment or relevant guidelines. In
some cases, the source of dyspnea or cough cannot be
identified. In these cases, consult with an HIV expert or
a pulmonologist.
Patient Education
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Shortness of breath and cough can be signs of an
opportunistic illness, especially in patients with low
CD4 counts. Patients should notify their health
care providers if they develop new or worsening
symptoms.
Patients taking antibiotics should be instructed to
take their medications exactly as directed and to call
their care providers if they experience worsening
fevers, shortness of breath, inability to take the
prescribed medications, or other problems.
Counsel smokers about the importance of smoking
cessation; refer to tobacco cessation programs and
prescribe cessation supports, as indicated.
References
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Section 5—Complaint-Specific Workups | 5–43
Centers for Disease Control and Prevention,
National Institutes of Health, HIV Medicine
Association/Infectious Diseases Society of America.
Treating Opportunistic Infections Among HIV-Infected
Adults and Adolescents. MMWR Recomm Rep. 2004
Dec 17;53(RR-15):1-112.
Huang L. Pulmonary Manifestations of HIV (Table
4). In: Peiperl L, Coffey S, Volberding PA, eds.
HIV InSite Knowledge Base [textbook online]; San
Francisco: UCSF Center for HIV Information; May
1998. Accessed February 7, 2006.
Mandell LA, Bartlett JG, Dowell SF, et al. Update of
practice guidelines for the management of communityacquired
pneumonia in immunocompetent adults. Clin
Infect Dis. 2003 Dec 1;37(11):1405-33.