Clinical presentation and significance of emerging opportunistic infections

In recent years the clinical face of the Acquired Immune Deficiency Syndrom e has changed significantly as a consequence of use of prophylaxis against Pneumocystis carinii pneumonia and combination antiretroviral therapy. In t his context several opportunistic pathogens have emerged as causes of clini cally important disease. Many of these infective agents have previously bee n defined by specific geographical locations. Their clinical presentation f requently mimics other (non) opportunistic infections with which they may c o-exist. The diagnosis is frequently delayed as the diagnostic possibility may not be in the clinician's differential diagnosis. Invasive procedures a re frequently required in order to secure a diagnosis. Despite treatment, p rognosis is often poor. Clinicians should be aware of these opportunistic p athogens in order that a timely diagnosis may be made and appropriate thera py given.