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months in the saliva).12,53

The disease is characterized by fever, lymphadenopathy (lymph

node hyperplasia), and exudative pharyngitis. Splenomegaly, hepatitis, pneumonitis, and central nervous system involvement may occur as rare complications from mononucleosis. The infection is generally

self-limiting in healthy individuals, with resolution occurring in

approximately 3 weeks without any specific rreatment.12.53

INFFcrlOUS DISEASES 635

Table 10-5. Common Complications from Human Immunodeficiency

Virus (HIV) and Acquired Immunodeficiency Syndrome and Associated

Medicral Treatment

Complication

Medication

Cardiomyop.lthy

May be reversed with reduction or discontinuation of inrerleukin-2, adriamycin, �

Interferon, ifosfamide, and fo�carnet

Cerebral toxoplasmosis

Trimcthoprim-sulfamethoxazole

Coccidioidomycosis

Amphorericlll B. fluconazole, or itraconazole

Congestive heart failure

Removal of all nonessential drugs followed by

administration of furosemide (Lasix); digoxin;

angiotensin-converting enzyme inhibition

Cryptococcral meningitis

Amphotericin B or fluconazole

Cytomegalovirus

Ganciclovir, foscarnet, cidofovir

Distal symmNnc poly-

Pain management using tricyclic antidepressants,

neuropathy

gabapentin, and narcotics for severe cases

Herpes simplex

Acyclovir� famciclovir, valacyclovir

Herpes zoster (shmgles)

Acyclovir, valacydovir, famciclovir, foscarnet

H IV-associared demen-

Antirerroviral therapy combining at least three

tia complex

drugs, t\vo of which penetrate the blood-brain

barrier

Histoplrasl11oslS

Amphotencln B or irraconazole

KJpmi's �arcoma

Radiotherapy, cryotherapy with liquid nitrogen,

daunorubicin hydrochloride, or doxorubicin

hydrochloride injections

Lymphomas

Chemotherapy: cyclophosphamide, doxorubicin,

vl11cnstine, bleomycin, methotrexate, leucovorin

Mycob,ulermlU aumm

Clanthromycln, rifabutin, ciprofloxacln, ethamcomplex

butol

Oral hairY leukoplakia

Acyclovir if symptoms preseO[

P,zeumocystls ca",,,,

Trimethoprim-sulfamethoxazole, dapsone, c1inpneumomll

damycin, pentamidine isethionate

Progressive multi focal

Antiretroviral therapy, acyclovir, i.v. cytosine,

leukoencephalopathy

adenosine-ara binoside, interferon-alphas

Pulmonary hypertension

Low-tlow 02 if hypoxia present, vasodilators,

mcluding nitroglycerin, hydralazine, nifedipine, lisinopril, and prostaglandin E