Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient



Título del documento: Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient
Revista: The brazilian journal of infectious diseases
Base de datos: PERIÓDICA
Número de sistema: 000290678
ISSN: 1413-8670
Autores: 1
Instituciones: 1Hospital Eduardo de Menezes, Fundacao Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais. Brasil
Año:
Periodo: Jun
Volumen: 5
Número: 3
Paginación: 154-157
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Microbiología,
Neumología,
Pneumocystis carinii,
Leishmaniasis visceral,
Tuberculosis,
VIH,
Infecciones oportunistas
Keyword: Medicine,
Diagnosis,
Microbiology,
Pneumology,
Pneumocystis carinii,
Visceral leishmaniasis,
Tuberculosis,
HIV,
Opportunistic infections
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