HIV in the ED
                                =============
þ PCP:
 - if PO2 <70, give dose of 60 of prednisone or equivalent IV an hour or two
   prior to giving Bactrim.

þ NNRTI Lactic Acid Syndrome
 - abdominal distension, pain
 - NVD
 - anorexia, wt loss
 - ? mitochondrial toxicity

þ Kidney stones from NNRTI

þ Adrenal Suppression
 - certain NNRTIs will increase serum level of certain steroids (e.g.,
   Flonase) so high they will cause adrenal suppression.

þ Acute HIV
 - p24Ag: old test, still useful to detect acute phase
 - detuned HIV Elisa: useful
 - rapid HIV Elisa: if negative, don't do Western Blot; maybe useful in ED
 - RNA PCR: detects before antibodies, but takes 1-2 weeks
 - CD4 counts: not useful, may be normal in acute infection, takes a couple of
   days

þ Suspect new HIV if:
 - New onset psoriasis
 - New onset Seborrheic dermatitis
 - ITP
 - Hep B or C
 - Pneumococcal pneumonia
 - HPV