Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, non-bloody, watery diarrhea, abdominal cramping, and significant weight loss. History significant for HIV with recent CD4 count <200 cells/ยตL. Symptoms are persistent, associated with nausea, anorexia, and occasional low-grade fever. No recent travel history or known sick contacts reported.
Clinical Examination Findings
General: Patient appears cachectic and chronically ill. Vitals: Tachycardic, afebrile. Abdomen: Soft, non-distended, hyperactive bowel sounds, diffuse mild tenderness on deep palpation, no rebound or guarding. Skin: Signs of dehydration (dry mucous membranes, decreased skin turgor). Neurological: Alert and oriented x3, no focal deficits.
Treatment Protocol
Initiate Trimethoprim-Sulfamethoxazole (TMP-SMX) 160/800 mg orally twice daily for 10 days, followed by secondary prophylaxis (TMP-SMX 160/800 mg daily) until CD4 count >200 cells/ยตL for at least 6 months. Ensure adequate hydration and electrolyte replacement. Monitor for drug-related adverse effects and skin rashes. Initiate or optimize Antiretroviral Therapy (ART) as per current HIV guidelines.