Today we discussed a case of a patient with known HIV disease (CD4 300-500, not on therapy) who presented with fever, diffuse adenopathy, and splenomegaly. The presumed cause is lymphoma.
The differential diagnosis would include:
Infections:
- HIV with high level viremia
- Mononucleosis syndromes (EBV, CMV, acute toxoplasmosis)
- Syphilis
- Disseminated TB
- In the more immunosuppressed host:
- Mycobacterium Avium Complex
- Bartonella Henselae
- Disseminated fungal infection (i.e. histoplasmosis)
- Non-infectious
- Lymphoma
- Multicentric Castleman's Disease
- Sarcoidosis
- Lymphoma
I have previously blogged about HIV here, here (with cryptococcal meningitis), and here (with PCP pneumonia).
I have blogged about lymphoma including staging here.
A review of the pathology of HIV associate lymphomas is here. An article reviewing the treatment of HIV associated lymphoma is here.
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