HIV/AIDS Associated Conditions

exp date isn't null, but text field is

Oral Candidiasis

ICD10 CODE: B37.0

Cause

  • Caused primarily by Candida albicans

Clinical features

  • Common in immunosuppressed, infants, and after prolonged antibiotic treatment
  • In advanced HIV it can present as intractable oral and oesophageal candidiasis. Angular cheilitis is also common

Management

Treatment LOC

Oral candidiasis

  • Nystatin tablets 500,000-1,000,000 IU every 6 hours for 10 days (chewed then swallowed)
  • Child <5 years: Nystatin oral suspension 100,000 IU every 6 hours for 10 days
  • Child 5-12years: 200,000 IU per dose every 6 hours for 10 days
 HC2

Oropharyngeal candidiasis

  • Fluconazole loading dose 400 mg, then 150-200 mg daily for 14-21 days
  • Child: loading dose 6 mg/kg, then 3 mg/kg daily
 HC3

 

Herpes Infections

ICD10 CODE: B00

Infections caused by virus herpes (simplex and zoster)

Cause

  • Both simplex and zoster infections can affect the face and oral cavity

Clinical features

  • Herpes simplex: cluster of painful vesicles around the mouth (cold sores or fever blisters). Can be recurrent
  • Herpes zoster: multiple small vesicles (2-3 mm) that ulcerate and coalesce to form larger ulcers on the oral mucosa
    • Commonly on the vermillion border, gingiva, dorsal tongue, and hard palate
    • Always present as a unilateral lesion and never cross the midline
    • Pre-eruption pain followed by the development of painful vesicles on the skin or oral mucosa that rupture to give rise to ulcers or encrusting skin wounds in the distribution outlined above
    • Post herpetic neuralgia may continue for years

Management

Treatment LOC

Herpes simplex

  • Reassure, it will resolve in most cases
  • For severe forms consider acyclovir 400 mg every 8 hours for 5-7 days
 HC2

Herpes Zoster

  • Acyclovir 800 mg 5 times daily for 5 days
  • May require antibiotic therapy if the area becomes secondarily infected
  • Analgesics, topical anaesthetic (e.g. lidocaine)
 HC4