Figure 2-6: Medical Complications of Substance Abuse That May Affect Differential Diagnosis of Injection Drug Users With HIV

Figure 2-6
Medical Complications of Substance Abuse That May Affect Differential Diagnosis of Injection Drug Users With HIV
Possible Diagnoses
Symptoms HIV Related Substance-Abuse Related
Constitutional:
  • Anorexia
  • Weight loss
  • Fever
  • Night sweats
  • Diarrhea
  • HIV infection
  • MAC
  • Cytomegalovirus
  • TB
  • Cocaine use
  • Methamphetamine use
  • Injection-related bacterial infections
  • TB
  • Heroin withdrawal
Pulmonary:
  • Chest pain
  • Cough
  • Shortness of breath
  • Bacterial pneumonia
  • PCP
  • Cocaine use
  • Marijuana use
  • Tobacco use
  • Aspiration pneumonia
  • TB
  • Pulmonary embolism
Neurologic:
  • Altered mental state
  • Psychosis
  • Seizures
  • Focal deficits
  • Peripheral neuropathy
  • HIV infection
  • Toxoplasmosis
  • Cryptococcosis
  • Progressive multifocal leukoencephalopathy (PML)
  • Human T-lymphotropic retrovirus type 1 (HTLV-1)
  • Intoxication and withdrawal from heroin
  • Methamphetamine-induced psychosis
  • Cocaine
  • Alcohol
  • Benzodiazepines
  • Drug-related chronic encephalopathy
  • Pyogenic central nervous system infection
  • Trauma
  • Alcoholic polyneuropathy
Dermatologic:
  • Pruritus
  • Rash
  • HIV dermatitis
  • HIV-related thrombocytopenia
  • Drug-related pruritus
  • Chronic hepatitis
  • Cellulitis
  • Alcohol/heroin-induced thrombocytopenia
  • Lymphedema
Miscellaneous:
  • Lymphadenopathy
  • Uremia
  • HIV-related lymphadenopathy
  • HIV-related nephropathy
  • Localized infection
  • Heroin nephropathy
Source: O'Connor et al., 1994b. Copyright 1994, Massachusetts Medical Society. All rights reserved.

From: Chapter 2—Medical Assessment and Treatment

Cover of Substance Abuse Treatment for Persons with HIV/AIDS
Substance Abuse Treatment for Persons with HIV/AIDS.
Treatment Improvement Protocol (TIP) Series, No. 37.
Center for Substance Abuse Treatment.

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