A rare case of an HIV-seronegative AIDS patient with Pneumocystis jirovecii pneumonia
Autor: | Qiaofei Zheng, Youzu Xu, Jiaxi Feng, Shuangquan Yan, Zhuolin Gao, Jing Huang, Hongguo Zhu |
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Rok vydání: | 2019 |
Předmět: |
Male
0301 basic medicine medicine.medical_specialty 030106 microbiology Case Report Disease Window period Pneumocystis carinii lcsh:Infectious and parasitic diseases Young Adult 03 medical and health sciences 0302 clinical medicine Medical microbiology Acquired immunodeficiency syndrome (AIDS) Antiretroviral Therapy Highly Active medicine Humans Pneumocystis jirovecii lcsh:RC109-216 030212 general & internal medicine AIDS patients Acquired Immunodeficiency Syndrome HIV-seronegative AIDS-Related Opportunistic Infections biology business.industry Pneumonia Pneumocystis virus diseases medicine.disease biology.organism_classification Pneumocystis jirovecii pneumonia Anti-Bacterial Agents CD4 Lymphocyte Count Treatment Outcome Infectious Diseases Immunology Etiology biology.protein RNA Viral Antibody business Viral load |
Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-7 (2019) |
ISSN: | 1471-2334 |
DOI: | 10.1186/s12879-019-4143-8 |
Popis: | Background As technology progresses, several highly sensitive human immunodeficiency virus (HIV) screening kits are being researched and developed to quickly and efficiently identify serum HIV antibodies within the non-window period. In individuals who are HIV-seronegative, HIV infections that are not within a window period are rare. In such cases, all antibody detection methods will fail, and misdiagnosing these patients will have catastrophic consequences. Case presentation A 22-year-old male Chinese patient with diffuse exudative lesions in both lungs and initial symptoms of cough and dyspnoea was diagnosed with Pneumocystis jirovecii pneumonia (PJP) by aetiological examination, and the patient’s plasma CD4+ T-cell count was extremely low. In China, PJP is prevalent in HIV-infected individuals. Pneumocystis jirovecii (P. jirovecii) has a high colonisation rate in patients with HIV infections. This patient was naturally suspected of being an HIV patient; however, serum HIV antibody tests were negative using both an enzyme-linked immunosorbent assay (ELISA) and a latex agglutination assay, and HIV was not detected by western blotting. Subsequently, the plasma HIV viral load was found to be extremely high on two repeated plasma HIV RNA tests, thus confirming HIV-seronegative acquired immunodeficiency syndrome (AIDS) in this patient. With administration of effective anti-P. jirovecii treatment and highly active antiretroviral therapy (HAART) after diagnosis, the patient’s disease condition was rapidly controlled. Conclusion This is the second reported case in China of an HIV-seronegative AIDS patient. Such cases are also rare worldwide. Although HIV-seronegative HIV infections are rare, AIDS should be considered in immunodeficient patients with opportunistic infections, even if the test results are HIV-seronegative. Plasma HIV RNA testing is important for such patients. Electronic supplementary material The online version of this article (10.1186/s12879-019-4143-8) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
Externí odkaz: |
Abstrakt: | Background As technology progresses, several highly sensitive human immunodeficiency virus (HIV) screening kits are being researched and developed to quickly and efficiently identify serum HIV antibodies within the non-window period. In individuals who are HIV-seronegative, HIV infections that are not within a window period are rare. In such cases, all antibody detection methods will fail, and misdiagnosing these patients will have catastrophic consequences. Case presentation A 22-year-old male Chinese patient with diffuse exudative lesions in both lungs and initial symptoms of cough and dyspnoea was diagnosed with Pneumocystis jirovecii pneumonia (PJP) by aetiological examination, and the patient’s plasma CD4+ T-cell count was extremely low. In China, PJP is prevalent in HIV-infected individuals. Pneumocystis jirovecii (P. jirovecii) has a high colonisation rate in patients with HIV infections. This patient was naturally suspected of being an HIV patient; however, serum HIV antibody tests were negative using both an enzyme-linked immunosorbent assay (ELISA) and a latex agglutination assay, and HIV was not detected by western blotting. Subsequently, the plasma HIV viral load was found to be extremely high on two repeated plasma HIV RNA tests, thus confirming HIV-seronegative acquired immunodeficiency syndrome (AIDS) in this patient. With administration of effective anti-P. jirovecii treatment and highly active antiretroviral therapy (HAART) after diagnosis, the patient’s disease condition was rapidly controlled. Conclusion This is the second reported case in China of an HIV-seronegative AIDS patient. Such cases are also rare worldwide. Although HIV-seronegative HIV infections are rare, AIDS should be considered in immunodeficient patients with opportunistic infections, even if the test results are HIV-seronegative. Plasma HIV RNA testing is important for such patients. Electronic supplementary material The online version of this article (10.1186/s12879-019-4143-8) contains supplementary material, which is available to authorized users. |
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ISSN: | 14712334 |
DOI: | 10.1186/s12879-019-4143-8 |