Medical Emergencies · single question
An HIV-positive patient needs extraction of tooth #19. For which reason would antibiotic prophylaxis be indicated?
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Correct answer: D. CD4 count below 250 cells/µL
- A. Incorrect. A platelet count of 150,000/µL is within normal range. Even at low counts (<50,000/µL), the concern is bleeding risk, not infection prophylaxis.
- B. Incorrect. Being on ART is a positive prognostic factor (helps control viral load and raise CD4) — it is not itself an indication for prophylaxis.
- C. Incorrect. Viral load alone does not determine antibiotic prophylaxis need; CD4 count is the primary immunocompetence marker for prophylaxis decisions.
- D. CORRECT. A CD4 count below 200–250 cells/µL indicates severe immunosuppression. At this level, the patient cannot mount an adequate immune response to prevent post-operative infection. Antibiotic prophylaxis is recommended for invasive dental procedures when CD4 count is in this range.
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