Aids ( acquired immunodeficiency syndrome)
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AIDS (Acquired Immunodeficiency Syndrome)
The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examination revealed right-sided pneumonitis. The following studies were performed:
|
Studies |
Results |
|
Complete blood cell count (CBC), p. 174 |
|
|
Hemoglobin (Hgb), p. 259 |
12 g/dL (normal: 14-18 g/dL) |
|
Hematocrit (Hct), p. 256 |
36% (normal: 42%-52%) |
|
Chest X-ray, p. 1014 |
Right-sided consolidation affecting the posterior lower lung |
|
Bronchoscopy, p. 587 |
No tumor seen |
|
Lung biopsy, p. 738 |
Pneumocystis jiroveci pneumonia (PCP) |
|
Stool culture, p. 855 |
Cryptosporidium muris |
|
Acquired immunodeficiency syndrome (AIDS) serology, p. 297 |
|
|
p24 antigen |
Positive |
|
Enzyme-linked immunosorbent assay (ELISA) |
Positive |
|
Western blot |
Positive |
|
Lymphocyte immunophenotyping, p. 306 |
|
|
Total CD4 |
280 (normal: 600-1500 cells/mL) |
|
CD4% |
18% (normal: 60%-75%) |
|
CD4/CD8 ratio |
0.58 (normal: >1.0) |
|
Human immune deficiency virus (HIV) viral load, p. 297 |
75,000 copies/mL |
1. Diagnostic Analysis: establish a diagnostic analysis of this case supported by a clinical guideline :
-summary of signficiant clinical data
– create a diagnostic rationale of the case including diagnosis and clinical data that support it
Critical Thinking Questions
1. What is the relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from AIDS?
2. Why does the United States Public Health Service recommend monitoring CD4 counts every 3 to 6 months in patients infected with HIV?
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