Deep fungal infections in HIV/AIDS patients

HIV/AIDS patients are susceptible to deep fungal diseases due to immunosuppression that facilitates opportunistic infections, especially fungal infections which are also the leading cause of death in HIV/AIDS patients

HIV causes disease by attaching to CD4+ helper T cells (also called T4 lymphocytes), which are white blood cells involved in the immune response against cancer and disease-causing viruses. When the number of CD4+ T cells decreases, the person is susceptible to a number of diseases. At that time, these opportunistic infections are the main cause of death in people with AIDS, including worms
Normally on human skin there is a dormant fungus. When a patient with HIV/AIDS causes immunodeficiency, loses the self-protection mechanism on the skin, creating favorable conditions for the fungus to enter the body, causing deep fungal diseases
AIDS is the final stage (stage) IV) of HIV. AIDS staging is based on clinical symptoms or CD4 T-cell counts and the percentage of CD4 T cells relative to cutaneous Lymphocytes. Opportunistic infections, especially fungal infections, are closely related to the immunocompromised state of the patient.

2.1. Candida
is the most common opportunistic infection, accounting for 90% of HIV infections. Clinical manifestations in the oropharynx and vagina.
Oropharyngeal candidiasis:
The patient feels pain, burning in the mouth, decreased taste, swallowing pain or pain behind the sternum Then appear many spots or white pseudomembranous patches, easy to peel with 4 clinical forms: pseudomembranous, red slip, hyperplasia and angular cheilitis. The disease is localized on the tongue, gums, inner cheeks, nasopharynx with pseudomembranous spots spreading gradually down the pharynx and esophagus.

Vaginitis caused by Candida. Symptoms:
In women: The disease causes itching, burning sensation in the vagina and vulva. Discharge is milky-white, milky, and does not smell, and a lot of it clings to the vaginal wall. May be accompanied by difficulty urinating, pain during intercourse. In men, a fungal infection can make the skin of the penis, anus, and scrotum red, slippery, and itchy. 2.2. Cryptococcosis
Cryptococcosis is the second most common fungal infection in HIV/AIDS patients due to inhalation of fungal spores, resulting in typical damage to the lungs.
Cryptococcus can spread to the brain and meninges. Manifestations of meningeal granuloma or cryptococcal meningitis are life-threatening and require aggressive therapy.
Sites of damage in disseminated infection include skin, ends of long bones, joints, liver, spleen, kidney, prostate, and other tissues.
Manifestations of cryptococcosis depend on the location of the lesion. Specifically as follows:
Central nervous system . Mild or no fever. In patients with AIDS, cryptococcal meningitis may cause few or no symptoms. Headache and confusion may occur. Other manifestations such as ophthalmic paralysis, facial paralysis, blindness (rarely) Lung infection. Cryptococcal pneumonia in disease up to AIDS may present as severe pneumonia, progressive pneumonia with life-threatening acute dyspnea, skin infection. Diffuse skin lesions may present as pustules, nodules, nodules, or ulcers, sometimes resembling acne, molluscum contagiosum, or basal cell carcinoma. 2.3. Histoplasmosis
Histoplasmosis was once rare, but is now increasing with AIDS. The clinical presentation is usually acute, subacute, or chronic with fever, weight loss, liver, spleen enlargement, lymphadenopathy, and other clinical manifestations. lungs such as cough, difficulty breathing Skin manifestations: red macules, papules and lumps with thick horny or necrotic nodes, pustules, folliculitis, patches of warts; Acne or rosacea or droplet psoriasis, ulcers or inflammation of subcutaneous tissue. In the oral mucosa: there may be lumps and bumps, ulcers appear in the palate, oropharynx, epiglottitis, nasal cavity... 2.4. Fungi caused by Penicillinosis:
Clinical manifestations
The most common systemic manifestations are fever, weight loss Other manifestations include: skin lesions, anemia, hepatomegaly, lymphadenopathy with or without splenomegaly. Skin lesions are pale pink papules like molluscum contagiosum, size 1-3cm in diameter, center of papule is concave, with necrotic papule in the center Lung symptoms such as cough, difficulty breathing

2.5. Fungal sporotrichosis
A chronic fungal infection of the skin and superficial lymph nodes with sporotrichosis causing diffuse abscesses and ulcers. Skin lesions are papules, scaly lumps, keratosis 1-2cm in size, ulcerated after. May be scattered or concentrated all over the body or hands, feet or oral mucosa. Injury to other organs such as eyes can be damaged with symptoms of conduction reduction, atrophy and prolapse of the retina, diffuse arthritis, .. lungs, liver, spleen, intestines and meninges are also affected. 3. Treating fungal infections in HIV/AIDS patients Antiretroviral therapy (ARV) is very important. Starting ART helps slow the progression of HIV and can reduce the chance of getting a fungal infection. Worm fungus needs to be detected and treated as soon as possible to try to avoid a serious infection. Treat with antifungal medication. Antifungal drugs are used exactly as prescribed by the doctor. Depending on the severity and condition of the disease, different routes of administration are indicated such as topical, oral, vaginal. Keeping your CD4 count above 200 can help prevent fungal disease. HIV-infected patients are most at risk for fungal infections when your CD4 count is below 200. Maintain good hygiene, use antiretroviral drugs, and avoid dusty areas such as construction sites and livestock areas. Livestock, poultry...helps prevent fungal infections in HIV/AIDS patients. Periodic health check-ups help detect diseases early, thereby planning treatment to achieve optimal results. Vinmec International General Hospital offers a package of Examination and Screening for social diseases to help customers detect diseases early and have effective treatment and prevent dangerous complications. The screening package for social diseases at Vinmec is for all ages, both men and women.
Results of the patient's examination will be returned to the home. After receiving the results, if abnormal problems are detected, you can use services from other specialties right at the Hospital with outstanding quality of treatment and customer service.