DOI: http://dx.doi.org/10.18203/2349-3933.ijam20212413

Clinical manifestation and initial treatment on infectious respiratory illnesses in HIV-infected patient: a case report

Komang Septian Trisna Jaya, Ketut Suryana

Abstract


Respiratory illnesses are common complication during the evolution of the disease in HIV-infected patients, mainly of infectious aetiology. Pneumocystis Pneumonia (PCP) is currently the most frequent cause of pulmonary infections in HIV patients, followed by bacterial pneumonia and TB. In this case report involves a 28 years-old male patient with HIV infection presented to the hospital with progressive dyspnoea, fever, non-productive cough and weight loss. Physical examination showed a decreased of oxygen saturation, oral thrush, and respiratory crackles in both lungs. The results of chest x-ray examination suggested a picture of pneumonia. The sputum was examined with Xpert MTB-RIF Assay and the results were negative. This patient was treated with cotrimoxazole in 2 double-strength (DS) tablets three times daily, dual therapy antibiotics combination with a beta-lactam and macrolide, oral fluconazole, also adjuvant corticosteroid of methylprednisolone. This initial treatment based on drug of choice for infectious respiratory illnesses in HIV-infected patient.


Keywords


HIV, Infectious respiratory illness, Corticosteroid, Antibiotics

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References


Benito N, Moreno A, Miro J.M, Torres A. Pulmonary infections in HIV-Infected patients: an update in the 21st century. Eur Respir J. 2012;39:730-45.

Fitzpatrick M.E, Kunisaki K.M, Morris A. Pulmonary Disease in HIV-Infected Adults in the Era of Antiretroviral Therapy. HHS Public Access AIDS. 2018;28:32(3):277-92.

Sarkar P, Rasheed H.F. Clinical review: Respiratory failure in HIV-Infected patients – a changing picture. Critical Care. 2013;17:228.

HIV-associated respiratory diseases. Lancelet. 1996.

Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. 2019.

Chandra A, Firth J, Sheikh A, Patel P. Emergencies related to HIV infection and treatment (part 1). African Journal of Emergency Medicine. 2013;3:142-49.

Dichter JR, Lundgren JD, Nielsen TL, Jensen BN, Schattenkerk J, Benfield TL et al. Pneumocystis carinii pneumonia in HIV-infected patients: effect of steroid therapy on surfactant level. Respiratory Medicine. 1999;93:373-78.

Franzetti F, Grassini A, Piazza M, Degl’Innocenti M, Bandera A, Gazzola L et al. Nosocomial Bacterial Pneumonia in HIV-Infected Patients: Risk Factors for Adverse Outcome and Implications for Rational Empiric Antibiotic Therapy. Infection. 2006;34:9-16.

World Health Organization. Tuberculosis care with TB-HIV co-management: Integrated Management of Adolescent and Adult Illness (IMAI), 2007. https://www.who.int/hiv/pub/imai/TB_HIVModule23.05.07.pdf. Accessed on 17 March 2021.

Masur H. Management of Patients with HIV in the Intensive Care Unit. Proc Am Thorac Soc. 2006;3:96-102.

Yudhawati R, Wijaksono W. Peran Steroid pada Pneumocystis Pneumonia Ditinjau Berdasarkan Imunopatogenesis. Jurnal Respirasi. 2019;57-64.

Ewald H, Raatz H, Boscacci R, Furrer H, Bucher HC, Briel M. Adjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV infection. Cochrane Database of Systematic Reviews. 2015;4:CD006150.

Azoulay E, Parrot A, Flahault A, Cesari D, Lecomte I, Roux P et al. AIDS-related Pneumocystis carinii Pneumonia in the Era of Adjunctive Steroids; Implication of BAL Neutrophilia. Am J Respir Crit Care Med. 1999;160:493-99.

Wilkin A, Feinberd J. Pneumocystis carinii Pneumonia: A Clinical Review. Am Fam Physician. 1999;60(6):1699-708.

Ide H, Yamaji Y, Tobino K, Okahisa M, Murakami K, Goto Y et al. Pneumocystis jirovecii pneumonia in an Immunocompetent Japanese Man: A Case Report and Literature Review. Hindawi Case Reports in Pulmonology. 2019.