Skin infections in HIV
Infection of the skin is more common in HIV than in seronegative people. The most frequent infections include:
| Organism | Presentation | Diagnosis/ investigation | Management |
|---|---|---|---|
| Methicillin-resistant Staphylococcus aureus | Usually cellulitis, skin abscesses, or folliculitis. | Clinical presentation or cultures | Incision and drainage, antibiotics including co-trimoxazole, doxycycline and clarithromycin. |
| Atypical mycobacteria | Often seen as subcutaneous nodules, plaques or ulcers. | Skin biopsy (may demonstrate granuloma) | Combination therapy with rifampicin, ethambutol and a macrolide, as well as surgery if needed |
| Treponema pallidum (syphilis) | More chancres and slower resolution with red-brown macules, broad distribution, sometimes affecting eyes and oral mucosa. | Skin biopsy, treponemal PCR testing. | Benzathine penicillin G. |
| Herpes simplex virus | Vesicles, ulcers, verrucous lesions in oral and anogenital regions. | Polymerase chain reaction or direct fluorescent antibody staining | Aciclovir |
| Varicella zoster virus (VZV) | Most frequently vesicles, bullae or ulcers in a dermatomal fashion | Clinical diagnosis, can use fluorescent antigen testing or PCR | Oral aciclovir, even if >72h from onset – foscarnet if resistant |
Take your subscriptions with you
Our mobile app allows you to access your interview and exam question banks wherever you are.