Hiv Cbl

Pneumocystis carinii pneumonia-bilateral, fluffy pulmonary infiltrates, prominent in the hilum and base of the lungs.

The course is typical. There are three phases of HIV infection. •The first (early, acute) phase is characterized by a high level of virus production and viremia; the symptoms are non-specific. • In the second (middle, chronic) phase, which was the initial presentation here, there is a smoldering, low-level HIV replication, predominantly in lymphoid tissues, which may last several years. • The final (crisis) phase is characterized by a breakdown of host defenses, viral replication, and the symptoms of persistent fever, fatigue, weight loss, and diarrhea.

. Pneumocystis of Lung - Low Power

Bronchial washings or sputum samples may be collected to diagnose pneumocystis

Cerebral Atrophy - Head CT The computerized tomographic (CT) scan demonstrates widening of the sulci and expansion of the cerebral ventricles, indicative of cerebral atrophy

HIV Encephalopathy, Brain, Luxol Fast Blue (LFB) Stain - Low Power This stain is used to highlight areas of demyelination, characteristic of HIV encephalopathy.

. HIV Encephalopathy - High Power

. Retina - Funduscopic Exam A funduscopic examination of the patient's retina revealed multiple retinal hemorrhages and regions of purulent exudate.

Small Bowel, Mycobacterium Avium Intracellular - Gross shows a nodular appearance of the entire length of the small bowel.

. Small Bowel, Mycobacterium Avium Intracellular

Colon, Cytomegalovirus (CMV) - Gross Cytomegalovirus infection of the colon presented in this patient as patchy ulcerations and pseudomembrane formation.

Colon, Cytomegalovirus (CMV) Low Power

Leukoencephalopathy (PML) - Gross PML is caused by a papovavirus which infects the oligodendroglia directly, causing necrosis

Toxoplasma Encephalitis - Low Power

. CNS Lymphoma - Medium Power

. Kaposi's Sarcoma - Clinical/Micro

What is the significance of the falling CD4 counts in this patient? HIV infection is stratified into three categories: CD4+ cells •greater than or equal to 500/µL;  •200­499/µL; • <200/µL.  If the count is above 500/µL, there is a low  probability of progression.  If the count is below 200/µL, or is rapidly  falling, the probability of progression is high.