Last reviewed: 1 Feb 2021
Last updated: 29 Jul 2020
Summary
Definition
History and exam
Other diagnostic factors
- male gender
- headache
- nausea and vomiting
- confusion
- depressed consciousness
- cutaneous ulcers or abscesses
Risk factors
- solid organ and hematopoietic stem cell transplant recipients
- HIV-positive and low CD4 T-cell count (<100 cells/mm³)
- immunosuppression
- structural pulmonary disease
- malignancy and chemotherapy
- male gender
- agricultural work
Diagnostic investigations
1st investigations to order
- Gram and acid-fast stains
- culture
- chest x-ray
Investigations to consider
- biochemical species typing
- thoracic CT scan
- CT head
- MRI head
- 16S rRNA sequencing and other polymerase chain reaction (PCR)-based techniques
Emerging tests
- identification and typing according to gyrB and rpoB genes
- matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS)
Treatment algorithm
Contributors
Authors
Division of Infectious Disease
Geneva University Hospital
Geneva
Switzerland
Disclosures
JG declares that he has no competing interests.
Division of Infectious Diseases
Hospital Clinic-IDIBAPS
Barcelona
Spain
Disclosures
JA is an advisory board member of Gilead Sciences and ViiV Healthcare.
Peer reviewers
Infectious Disease Specialist
Alabama Infectious Diseases Center
Huntsville
AL
Disclosures
AH declares that he has no competing interests.
Associate Professor of Medicine
Division of Pulmonary and Critical Care
Harborview Medical Center
University of Washington
Seattle
WA
Disclosures
MN declares that he has no competing interests.
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