Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
12 - Emergency evaluation and care
from Part II - General issues in the care of pediatric HIV patients
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
Summary
Introduction
Most pediatric patients with HIV infection in rich countries live in major cities. However, cases have been reported in smaller cities and rural areas. Any clinician who sees sick children in an acute care setting may treat children with HIV and should be familiar with the atypical and sometimes life-threatening diseases that affect these children.
HIV-infected children average 1.2 visits to the emergency department (ED) and 15 ambulatory care visits per year [1]. Children who meet the case definition for pediatric AIDS average 2 ED visits and 18 ambulatory care visits each year [1]. HIV-infected children present to the ED with different complaints, are more likely to have diagnostic or therapeutic procedures performed and are more likely to be admitted to the hospital than uninfected children [2]. HIV status may not be known at the time of an ED visit. Manifestations of HIV infection may not be recognized [3, 4].
Much of the early improvement in HIV-related mortality was related not to new antiretroviral therapies, but to the prompt and effective treatment of the opportunistic infections associated with HIV disease. Even with the wide variety of antiretroviral therapies currently available, the quick recognition and aggressive treatment of the infectious complications of HIV infection in children may be life saving. Initial diagnosis of HIV infection may be made when a child presents with an acute and possibly life-threatening illness. Physicians must know the right questions to ask and the signs to look for.
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- Textbook of Pediatric HIV Care , pp. 168 - 187Publisher: Cambridge University PressPrint publication year: 2005