CASE HISTORY - CASE 7
A 32 year old male is admitted into Accident & Emergency with worsening shortness of breath and fever. He looks very unwell.
When questioned, he reports:
- Shortness of breath with a persistent non-productive cough accompanied by fever.
- HIV positive for 6 years (used to be an IV drug user, homosexual experiences for the last 10 years).
- CD4+ lymphocyte count of <200/mm³ (last test 3 weeks ago).
- Infected with Hepatitis B.
- Previous oral candidiasis.
- Non-smoker and only occasional drinker (5-10 units/week).
- Blood pressure of 100/50 mm Hg
- Heart rate of 120 bpm
- Fever of 38.7 °C
- Raised respiratory rate of 30/min
- Central cyanosis.
Because of his low diastolic blood pressure and raised respiratory rate, he was immediately transferred to the Intensive Care Unit. Faecal samples and bronchoalveolar lavage samples were taken for cultures to identify any infecting organisms.
Despite intensive treatment, he rapidly deteriorates and dies a few hours later.