Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection Case Study Questions: Aside from HIV, what is your diagnosis? Support your clinical diagnosis. Could any of the patient’s problems have been caused by drug therapy? What drug, dosage form, schedule, and duration of therapy are best for treating this patient?
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year.
Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child.
Physical Examination as follows:
General: thin, anxious, acutely ill-appearing, young white man with tachypnea
Neck/LN: slight cervical lymphadenopathy, thyroid normal
Lungs/Thorax: CTA, slight axillary lymphadenopathy
Labs
Chest X-ray: Bilateral subtle infiltrates
Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like
Assessment: breakthrough opportunistic infection
Case Study Questions:
- Aside from HIV, what is your diagnosis? Support your clinical diagnosis.
- Could any of the patient’s problems have been caused by drug therapy?
- What drug, dosage form, schedule, and duration of therapy are best for treating this patient?
Opportunistic pneumonias are important contributors to morbidity and mortality among HIV-associated pulmonary sequelae.
Bacterial, mycobacterial, fungal, viral, and parasite pneumonias all fall under the broad category of HIV-associated opportunistic pneumonias.
The most common type of opportunistic pneumonia is bacterial pneumonia.
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