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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