By Joshua O. Benditt, et al. American College of Chest Physicians
Instantly from the ACCP serious Care drugs Board assessment 2009 path, this article covers each subject in a concise, easy-to-use structure. Use as a self-study source to organize for the serious care drugs subspecialty board exam.
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37 In this trial, IL-2 did not enhance bacillary clearance or improvement in symptoms in HIV-seronegative adults with drugsusceptible TB. A significant change has recently occurred regarding TB infection. For many decades, the terms “preventive therapy” and “chemoprophylaxis” were used to describe the status of persons with a positive tuberculin test but no symptoms or signs of active TB. The word preventive was inaccurate in that it referred to use of an agent such as isoniazid to prevent development of active TB in persons known or likely to be infected with M tuberculosis; it was not intended to imply prevention of true primary infection.
15 With HIV infection, Candida may present in a hierarchical pattern. With CD4+ counts in the 400 to 600 cells/L range, women may develop recurrent vulvovaginal candidiasis. At CD4+ levels of ∼250 cells/L, oral candidiasis is the expected clinical entity. The clinical presentation of odynophagia in a patient with oral candidiasis and a CD4+ count of Ͻ100 cells/L strongly raises the diagnosis of Candida esophagitis. These candidal infections generally respond well to therapy, and because of this, primary prophylaxis is not generally recommended.
This has been referred to as chronic enteroviral meningoencephalitis. Common variable immunodeficiency (CVI) is associated with functional abnormalities of both B and T cells but is usually classified as a primary antibody deficiency syndrome. Characterized by hypogammaglobulinemia and recurrent bacterial infections, CVI usually does not become clinically Table 4. Pathogens in Patients With Defective Humoral Immunity Disorders of Immunoglobulin Production Streptococcus pneumoniae Haemophilus influenzae Encapsulated strains of Gram-negative bacilli Enteroviruses, particularly echovirus 24 Influenza viruses Arboviruses Pneumocystis jiroveci (formerly P carinii) Giardia lamblia Asplenic State or Splenic Dysfunction Streptococcus pneumoniae Capnocytophaga canimorsus Babesia microti Plasmodium spp Haemophilus influenzae Neisseria spp 19 apparent until the second or third decade of life.
ACCP Critical Care Medicine Board Review, 20th Edition by Joshua O. Benditt, et al. American College of Chest Physicians