Abstract
Introduction: HIV infection leads to a decrease in the CD4 count ultimately leading to the development of AIDS. Under this condition, within the body of the host several OIs manifest their pathological effects. With progressive decrease in CD4 count and with HIV disease progression, the pathogenic effects of these OIs increase several folds. Under this condition, dissemination of multiple infections is extremely common. Report of case: A 28 year old male patient presented with complaints of weakness, fever, weight loss, dry cough, respiratory distress and dimness of vision. He was HIV sero positive with CD4 count of 0.1 cells/μl of blood. Indirect opthalmoscopic investigations revealed Cytomegalovirus (CMV) retinitis. Treatment with wide spectrum antibiotics could not improve his respiratory distress. Broncoscopy or lung biopsy could not be performed due to his poor general condition. CMV PCR revealed high titre (5.1×107 copies of DNA/ml serum). In anticipation that his respiratory distress might be caused due to infiltration of CMV into the lungs and also to combat retinitis, i.e. Ganciclovir was started. On treatment, patient became afebrile and there was significant radiological improvement of pneuomonitis. He later developed urinary tract infection of Pseudomonas aeruginosa and was treated with Cotrimoxazole (800 mg). With HAART, CD4 increased to 66. Patient’s visual acuity improved slightly in left eye. Discussion: Early detection and prompt treatment of HIV and associated OIs is of utmost importance. The symptoms of Cytomegalovirus Retinitis are subtle and nonspecific. So, the clinician must have a high index of suspicion for diagnosing CMV retinitis. At extremely low CD4 counts, a disseminated cytomegalovirus infection should always be considered as a likely etiology of Pneumonitis. A CD4 Count of 0.1 cells/μl has made the case more novel. The initiation of HAART at extremely low CD4 counts may boost the immune system with rapid increase in CD4 coun
Highlights
HIV infection leads to a decrease in the CD4 count leading to the development of AIDS
At extremely low CD4 counts, a disseminated cytomegalovirus infection should always be considered as a likely etiology of Pneumonitis
The initiation of HAART at extremely low CD4 counts may boost the immune system with rapid increase in CD4 count
Summary
Detection and proper treatment is of utmost importance to combat this condition. With the advent of antiviral therapy, major advances in the treatment and prevention of CMV infection has been achieved This has lead to dramatically improved outcomes in case of immunocompromised hosts [12]. Pseudomonas can invade the bloodstream from the urinary tract and is the source of nearly 40 percent of Pseudomonas bacteremias and may complicate the scenario by developing systematic diseases like bacteremic pneumonia, sepsis and meningitis which are associated with extremely high mortality rates [13].So proper treatment is of utmost importance. HAART increased his CD4 count to 66 cells/μl blood During his follow up, he developed symptomatic Pseudomonas aeruginosa infection in the urinary tract.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
