TY - JOUR
T1 - Refractory hypoxia in an HIV-infected patient-a diagnostic challenge
AU - Wayangankar, Siddharth A.
AU - Golwala, Harsh
AU - Bronze, Michael S.
PY - 2012/9
Y1 - 2012/9
N2 - A 39-year-old man with HIV presented to the emergency department for evaluation of dyspnea accompanied by fever, diffuse chest discomfort, dry cough, and fatigue for past 1 week. The patient described his dyspnea as exertional progressing over 1 week to rest dyspnea. He was prescribed antiretroviral therapy but was noncompliant. He had no paroxysmal nocturnal dyspnea, orthopnea, rash, oral thrush, or diarrhea. His last record CD4+ lymphocyte count and HIV viral load were 43 cells/mm3 and 178 0000 copies/mL, respectively. Vital signs included a temperature of 101F, heart rate of 115 beats per minute, respiratory rate of 16 per minute, and pulse oxygenation of 91% on room air. Lung examination revealed decreased breath sounds bilaterally, and the remainder of the examination was unrevealing. Laboratory findings revealed leukocytosis and increased serum lactate dehydrogenase of 577 U/L (90-190 U/L), and chest radiograph showed a right lower lobe infiltrate and perihilar, bilateral interstitial infiltrates (Fig. 1A).
AB - A 39-year-old man with HIV presented to the emergency department for evaluation of dyspnea accompanied by fever, diffuse chest discomfort, dry cough, and fatigue for past 1 week. The patient described his dyspnea as exertional progressing over 1 week to rest dyspnea. He was prescribed antiretroviral therapy but was noncompliant. He had no paroxysmal nocturnal dyspnea, orthopnea, rash, oral thrush, or diarrhea. His last record CD4+ lymphocyte count and HIV viral load were 43 cells/mm3 and 178 0000 copies/mL, respectively. Vital signs included a temperature of 101F, heart rate of 115 beats per minute, respiratory rate of 16 per minute, and pulse oxygenation of 91% on room air. Lung examination revealed decreased breath sounds bilaterally, and the remainder of the examination was unrevealing. Laboratory findings revealed leukocytosis and increased serum lactate dehydrogenase of 577 U/L (90-190 U/L), and chest radiograph showed a right lower lobe infiltrate and perihilar, bilateral interstitial infiltrates (Fig. 1A).
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U2 - 10.1016/j.ajem.2011.06.021
DO - 10.1016/j.ajem.2011.06.021
M3 - Article
C2 - 21871757
AN - SCOPUS:84865526493
SN - 0735-6757
VL - 30
SP - 1322.e5-1322.e6
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 7
ER -