Mức độ và mức độ nghiêm trọng của đột quỵ phụ thuộc vào thời gian và mức độ của diminishment lưu lượng máu não cho các khu vực bị ảnh hưởng, cũng như dòng chảy tài sản thế chấp đối với khu vực đó. | COLLAGEN VASCULAR DISEASE 235 TAB LE 9-7 CD4 COUNTS AND CLINICAL SYMPTOMS CD4 COUNTS SYMPTOMS CONDITIONS 200-500 Oral candidiasis 50-200 Pulmonary PCP TB histoplasmosis Esophageal candidiasis cryptococcal meningitis toxoplasmosis cryptosporidial diarrhea ITP 50 Disseminated mycobacterium avium intracellular CMV Kaposi s sarcoma temporal wasting parietal hair loss lipodistrophy Headaches and neurologic complaints must be fully evaluated. CT scan should be ordered if the patient has a headache toxoplasmosis along with a lumbar puncture including an opening pressure fungal cultures cryptococcal antigen and India ink staining to identify cryptococcus. CSF protein and glucose levels may be relatively normal despite fungal infections. Treatment Treatment begins with suspicion for and confirmation of HIV status. Identify underlying opportunistic infections and treat accordingly. Be suspicious of TB and order respiratory isolation when in doubt. HIV Exposure Management TAB LE 9-8 BODILY FLUIDS AND RISK OF TRANSMISSION OF HIV POSSIBLE RISK MINIMAL RISK UNLESS BLOOD CONTAMINATION Amniotic Emesis Blood Nasal secretions CSF Saliva Peritoneal Sputum Pericardial Stool Pleural Saliva Semen Sweat Synovial Tears Vaginal secretions Urine Contact by health care worker HCW or patient sexual assault patient with bodily fluid from a person known to be or potentially infected with HIV requires prompt intervention. Patients on retroviral therapy who are compliant may have very low titers of virus in bodily fluids and pose low risk. Many patients are not compliant or are infected and unaware of their HIV status. CDC monitors exposures to HIV by HCWs. Very few HCWs acquire HIV as a result of occupational exposure. Not infrequently ED physicians are called upon to evaluate and recommend treatment for HCWs who are exposed on the job. Risk of acquisition of HIV infection is related to type of contact surface splash superficial or deep injection site of contact intact dermis broken inflamed .
