i bc27f85be50b71b1 (198 page)

636

AClfrE CARE HANDBOOt.;. FOR I)HY')ICAI THfRAI'I'" T\

Table 10-5. COllt"med

Complication

Medication

Toxic neuronal neuropa

May be reversed with discontlOu:Jtlon or

thy: neuropathy caused

reduction in the following: zalcltahine,

by certain medications

didanosine, and stavudine

Tuberculosis

Four-drug regimen: i'ioniazid, nfamplIl,

pyrazinamide, and cthamhurol

Sources: Data frolll MD Chettlin. Cardiovascular C:ompl!c3t10n\ of IIiV InflXtJon. In

l\tA Sande, PA Volberding. The Medical M31l.lgement of AIDS. Philadelphia: Saun·

den�. 1999;278.280; CA Kirton. Oncologic Conditions. In CA Kirton. D T;lloua. K

Zwolski (cds). Ilandbook of IIiV/AIDS Nursing. St. loUIs: l\to<,hy. 2001:27�. 278-

279; RW Price. Management of the Neurologic CompliC;1tions of HIV-1 infeuiull and

AIDS. In MA Sande. PA Volberdlllg (eds). The Medical Managemenr of AID�. PhiladelphIa: Saunders. 1999;227,229,231-232; K Zwolski. Fungal lnfecnons. In CA Kirton, D Talona, K Zwolskl (cds). llandbook of 11IV/AIDS Nur\lI1g. \1. LoUIs: .\losby.

2001;262,266.270; K Zwolskl. Paramic Infccllons.ln CA KIrton. DT'llona. K

Zwolski (cds). Handbook of IIIV/AIDS Nursing. St. louis: l\tosby, 2001;294; K

Zwolski, 0 Talorra. Bacterial Infections. In CA Kirton. D Talon.l. I..: 7wolskl (ed').

Handbook of IIIV/AIDS Nursing. St. I.ouis: Moshy, 2001 :2.16.248-49; and K Zwolski. Viral lnfcctions. In CA Kirton, D Talona. " Zwol!oki (cds). II.mdbook of I II VI AIDS Nursing. St. Louis: l\tosby, 200 I :.303, 310-3 II. 3 U. J 1 s.

If management of mononucleosis is necessary, it Illay consist of the

foliowing12•B:

• Corticosteroids in cases of severe pharyngitis

• Bed rest during the acme stage

• Saline throat gargle

• Aspirin or acetaminophen for sore throat and fever

Cytomegalovints IIt(echolt

CMV is a member of the herpesvirus group [hat can be found in all

body secretions, including saliva, blood, urine, feces, semen, cervical

secretions, and breast milk. CMV infection is a common viral II1fection that is asymptomatic or symptomatic. C�lV infection can remain latent after the initial introduction into the body and can become

opportunistic at a later point in time.

INFEcrJOUS DISEASES 637

If CMV infection is symptomatic, clinical presentation may be a

relatively benign mononucleosis in adults, or in patients with HIV

infection, manifestations such as pneumonia, hepatitis, encephalitis,

esophagitis, colitis, and retinitis can occur.

CMV is usually transmitted by prolonged cOntact with infected

body secretions, as well as congenitally or perinatally."·"

Management of CMV infection may consist of the following!!·,,:

• Antiviral agents

• Corticosteroids

• Immune globulins

• Blood transfusions for anemia or thrombocytopenia

• Antipyretics

Toxoplasmosis

Toxoplasmosis is a systemic protozoan infection caused by the parasite Toxoplasma gOlldii, which is primarily found in cat feces. Transmission can occur from three mechanisms: (1) eating raw or inadequately cooked infected meat or eating uncooked foods that

have come in contact with contaminated meat; (2) inadvertently

ingesting oocYStS that cats have passed in their feces, either in a cat litter box or outdoors in soil (e.g., soil from gardening or unwashed fruits or vegetables); and (3) transmission of the infection from a

woman to her unborn fetlls. Fetal transmission of T. gandii can result

in mental retardation, blindness, and epilepsy,55

linical manifestations can range from subclinical infection to

severe generalized infection, particularly in immunocompromised

individuals, to death.

The m.nagemenr trend of tOxoplasmosis is through prevention by

safe eating habits (thoroughly cooking meats, peeling and washing ftuits

and vegetables) and minimizing the contact with cat feces when pregnant, along with keeping the cat indoors to prevent contamination,55

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