Case report about an initial diagnosis of HIV-infection in a young sailor through two AIDS-defining diseases with lethal progression

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ANAMNESIS: We saw a previously healthy 30-year-old Southeast-Asian sailor with progredient coughing and fever.

EXAMINATION: We found an atypical pneumonia along with a positive HIV-test. We performed a bronchial lavage and further diagnostics for opportunistic infections. The lab work showed a viral load of 3340 000 copies/ml and a CD4-cell-count of 36/µl.

DIAGNOSIS: HIV late presenter in CDC stadium C3 with Pneumocystis jirovecii and CMV pneumonia.

THERAPY: We treated with Meropenem, Moxifloxacin, Cotrimoxazol, Ganciclovir and Genvoya.

CLINICAL COURSE: Due to a cardio-pulmonal deterioration invasive ventilation was necessary. In the end the patient died of multi organ failure twelve days after admission despite intensive care, hemodialysis and prone positioning.

CONCLUSION: This case demonstrates the difficulties in the pharmacotherapy and with drug interactions in a HIV late presenter with multi organ failure. Consultation and advice of the hospital pharmacy and the antibiotic stewardship team was vital for treating this patient. In the end cases like the portrayed should be treated in specialized clinics.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:147

Enthalten in:

Deutsche medizinische Wochenschrift (1946) - 147(2022), 20 vom: 11. Okt., Seite 1330-1335

Sprache:

Deutsch

Weiterer Titel:

Fallbericht über die Erstdiagnose einer HIV-Erkrankung eines jungen Seemanns durch 2 AIDS-definierende Erkrankungen mit letalem Intensivverlauf

Beteiligte Personen:

Herpertz, Gerrit [VerfasserIn]
Haerting, Matthias [VerfasserIn]
Radke, Oliver [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
FV9J3JU8B1
Ganciclovir
Journal Article
Meropenem
Moxifloxacin
P9G3CKZ4P5
U188XYD42P

Anmerkungen:

Date Completed 06.10.2022

Date Revised 15.11.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1055/a-1911-4567

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM347105181