A Case of Human Immunodeficiency Virus (HIV) Infection Leading to Acquired Immunodeficiency Syndrome (AIDS)-Related Pneumocystis Pneumonia

TL;DR

A woman with undiagnosed HIV developed AIDS-related Pneumocystis pneumonia, emphasizing the need for early HIV screening.

Contribution

This case report underscores the clinical importance of early HIV diagnosis to prevent AIDS-related complications.

Findings

A 39-year-old woman presented with PCP and a CD4 count of 2 cells/mm³, indicating advanced AIDS.

Delayed HIV diagnosis led to severe immunosuppression and opportunistic infection.

The case emphasizes the necessity of routine HIV screening to prevent advanced disease.

Abstract

Pneumocystis pneumonia (PCP) is a serious pulmonary infection that frequently occurs in individuals with advanced human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS), especially when profound immunosuppression is present. Delayed HIV diagnosis may lead to progression to AIDS and subsequent development of opportunistic infections, including PCP.

A 39-year-old woman presented to the emergency department with a two-week history of persistent cough, chest pain, and shortness of breath. She reported intermittent illness over the preceding five months, along with an unintentional 40-pound weight loss. On admission, she was febrile, tachypneic, tachycardic, and hypoxic. Chest computed tomography revealed bilateral pneumonia. Physical examination identified white oral plaques suggestive of fungal infection. Laboratory evaluation demonstrated a CD4 count of 2 cells/mm³. Bronchoscopy confirmed the diagnosis of PCP in the context of AIDS secondary to HIV infection.

The patient received treatment with trimethoprim-sulfamethoxazole, fluconazole, and high-dose prednisone for hypoxia, in addition to initiation of highly active antiretroviral therapy. Counseling was provided regarding her diagnosis, medication adherence, and the necessity of follow-up care. She was discharged with instructions for close outpatient follow-up with a primary care physician and referral to an HIV specialist.

This case highlights the critical importance of routine HIV screening, since delayed diagnosis can result in advanced disease, increased morbidity, and greater healthcare expenditures.

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