艾滋病相关呼吸道感染讲解材料.pptVIP

HIV/AIDS相关呼吸道感染 HIV-related respiratory infections;HIV/AIDS; ;CD4+T细胞功能缺失导致进展至艾滋期;治疗及难点;［治疗］（treatment）;［治疗］（treatment）;［治疗］（treatment）;Chief Complaint:Cough .sputum for 4 months,with chest tightness and shortness of breath for days. Present illness: The patient often complained of cough and sputum in the past 4 years.Although he was accepted some treatment in local hospital for 14 days ,but he said it is invalid.The symptoms seemed to be worse.Until 10 days ago ,these above symptoms developed to cough persistently and occured fatigue,hoarse,aching muscles.High-grade fevers and shortness of breath made the person more and more painful.In these days ,the temperature waved between 39-40,so the patient came to our hosipital .Since the diease coming on ,spirt .sleep.appetite is bad,stool and urine is normal.;病例;Past history: He was born in ++.and always lived in Qinghai province.His living condition were good.NO bad personal habits and customs. Family history: His parents have both deads.His wife and child are lively and well.No inherited diease or infection diease in his family. ; Physical examination ;相关信息：;查体：;;;;;;;;;诊断及鉴别诊断;鉴别;辅助检查：;血气分析;血生化;其他：;2月2日： 病毒系列阴性。 痰革兰氏染色检测到正常菌群。 痰培养+药敏未见异常 2月3日： 痰真菌阳性。;病情分析及治疗方案;AIDS;艾滋病相关呼吸道感染;诊断流程(一）当CD4+大于200/ul时;诊断流程（二）当CD4+小于200/ul时;诊断标准;HIV/AIDS相关呼吸道感染;3、肺结核;AIDS合并肺结核特点：;AIDS合并TB;鸟型分支杆菌感染;真菌感染--卡式肺孢子虫肺炎(PCP);卡式肺孢子虫肺炎;AIDS合并PCP;;2006年中华内科学关于肺孢子菌肺炎治疗方案非急性轻中症病人：（吸入空气氧分压大于70mmHg,) ;急性重症病人：（吸入空气氧分压小于70mmHg,);1、念珠菌：最常见。 2、曲霉菌：病情凶险。 3、新生隐球菌。神智异常+肺部病变。 治疗：常用药物有伊曲康唑、酮康唑、伏立康唑等。AIDS患者常需联合应用二种以上的抗真菌药物。;HIV/AIDS其他表现：;真菌感染;病毒感染--巨细胞病毒感染（CMVP）;AIDS合并CMVP;EB病毒;口腔毛状白斑;寄生虫感染;医务工作者如何做好职业??露后预防;Thank You !