Like toxoplasmosis or cryptococcal meningitis. Suspect in HIV-patient with low T-cell count.
Suspect undiagnosed HIV in patient with past risk factors, or certain clinical findings:
- Shotty lymphadenopathy in atypical locations: axillary, posterior cervical, occipital, & especially epitrochlear.
- Chronic diarrhea or weight loss.
- Seborrheic dermatitis: extensive upper & central facial scaly erythema (not dandruff).
- History of Zoster at a youngish age (<50)
- Oral stigmata:
- thrush [on buccal mucosa & palate, not so much the tongue]
- hairy leukoplakia [corrugated white streaks on sides of tongue]
- Kaposi’s sarcoma [ecchymoses on the palate]
- severe gingivitis
- Certain abnormal laboratory tests:
- thrombocytopenia [platelets <100,000]
- lymphopenia [absolute lymphocyte count <1,000]
- elevated serum globulins [total protein minus the albumin = >4,0 g/dL]
- very low HDL cholesterol [<25 mg/dL]
See posting Acute Headache – 3.