Rapid emergence of cryptococcal fungemia, Mycobacterium chelonae vertebral osteomyelitis and gastro intestinal stromal tumor in a young HIV late presenter: a case report.
Background: Highly active antiretroviral therapy has significantly changed the natural history of HIV infection, leading to a dramatic reduction of HIV-related morbidity and mortality. Late Presenters, Very Late Presenters and AIDS presenters still represent, also in Europe, including Italy, a huge...
| Publicado en: | BMC Infectious Diseases Vol. 18; no. 1 |
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| Autores principales: | , , , , , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
BioMed Central
12/27/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133735165&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133735165 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 12/27/2018 vid: 18 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 133735165 133735165 NLM30587143 133735165 10.1186/s12879-018-3573-z NLM30587143 133735165 ppct: 1 formats: tig: atl: Rapid emergence of cryptococcal fungemia, Mycobacterium chelonae vertebral osteomyelitis and gastro intestinal stromal tumor in a young HIV late presenter: a case report. aug: au: Marino, Andrea Caltabiano, Eleonora Zagami, Aldo Onorante, Anna Zappalà, Carmela Locatelli, Maria Elena Pampaloni, Alessio Scuderi, Daniele Bruno, Roberto Cacopardo, Bruno affil: Division of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy sug: subj: Gastrointestinal Neoplasms Complications HIV Infections Diagnosis Mycobacterium Infections Diagnosis Cryptococcosis Complications Spinal Diseases Complications Osteomyelitis Complications Diagnosis, Delayed Cryptococcosis Fungemia Microbiology Cryptococcosis Microbiology Gastrointestinal Neoplasms Microbiology Gastrointestinal Neoplasms Human Immunodeficiency Virus Spinal Diseases Microbiology Adult Gram-Positive Bacteria HIV Infections Complications AIDS-Related Opportunistic Infections Microbiology Osteomyelitis Microbiology Fungemia Complications Cryptococcus Fungemia Diagnosis AIDS-Related Opportunistic Infections Diagnosis Osteomyelitis Diagnosis Cryptococcosis Diagnosis HIV Infections Microbiology Mycobacterium Infections Complications Spinal Diseases Osteomyelitis Fatal Outcome Male Adult: 19-44 years Male ab: Background: Highly active antiretroviral therapy has significantly changed the natural history of HIV infection, leading to a dramatic reduction of HIV-related morbidity and mortality. Late Presenters, Very Late Presenters and AIDS presenters still represent, also in Europe, including Italy, a huge challenge in terms of diagnostic and therapeutic management.Case Presentation: A 35-year-old male with a history of fever and back pain. HIV test resulted positive with a high HIV Viral Load and a very low T-CD4 number of cells (5 cells/mm3). Imaging investigations revealed multiple vertebral and pulmonary lesions together with abdominal and thoracic lymphadenopathy. Blood cultures were positive for Cryptococcus neoformans and for Staphylococcus haemolyticus. Lymphnode biopsy resulted positive in PCR for Non-Tuberculosis Mycobacteria (Mycobacterium chelonae). A gastric biopsy also revealed a GIST. The patient also had CMV DNA positive. Although we performed antiretroviral therapy and specific-therapies for each disease, he was transferred to intensive care unit where he died due to an Acute Respiratory Distress Syndrome.Conclusion: The reported case is unusual due to the relevant number of opportunistic diseases (both infectious and tumoral) emerging not long after the HIV infection had been diagnosed. Late presenters HIV patients and AIDS presenters still represent a challenge, which is often too complex for clinicians to deal with. In spite of proper management, the risk of suboptimal results cannot be excluded. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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