Scenario 3 Mrs H (29 years) came to the hospital because of complaining for 3 days is experiencing weakness, dizziness, nausea, mouth ulcers in his mouth and also very harming. Mrs H claims to be undiagnosed HIV since 2 years ago but for 7 days is not buying his HIV medication consisting of: Zidovudine 300 mg PO BID, 40 mg PO BID Lamivudine, Nevirapine 200 mg PO BID because Mrs H claims to be found out that she was pregnant 6 weeks. Based on the results of the laboratory, the levels of hemoglobin = 8 grams/dl and CD4 = 490 cells/µL. Diagnosis: HIV with anemia and Oral candidiasis. By a doctor, Mrs H was given the drug Tenovovir 300 mg SID as a replacement for Zidopudine; Fluconazole 200 mg BID, iron Supplements and folic acid while Lamivudin and Nevirapine continued.
Problem Identification 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
What is the definition of HIV and Oral Candidiasis? The etiology and Risk Factors of HIV and Oral Candidiasis! Signs and symptoms of HIV and Oral Candidiasis! Pathophysiology of HIV and Oral Candidiasis! Diagnosis of HIV and Candidiasis Oral! Interpretation of laboratory Data! Analysis Of The Drug! Algorithm for HIV Therapy with Oral Candidiasis! SOAP! Monitoring Counselling, Information and Education for patients.
1. Definition a. HIV HIV stands for human immunodeficiency virus. HIV is a virus spread through certain body fluids that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These special cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases. Opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS (CDC,2007). b. Oral Candidiasis Oral candidiasis is an opportunistic infection in oral mucosa caused by fungi of the Candida albicans. In addition oral candidiasis can be caused by C. Tropicalis, C. krusei, C. parapsilosis, C. Guilliermondi. It is common and underdiagnosed among the elderly, particularly in those who wear dentures and in many cases is avoidable with a good mouth care regimen. It can also be a mark of systemic disease, such as diabetes mellitus and is a common problem among the immunocompromised.