19 Mar The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examinatio
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:
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
Acquired immunodeficiency syndrome (AIDS) serology, p. 297
Enzyme-linked immunosorbent assay (ELISA)
Lymphocyte immunophenotyping, p. 306
280 (normal: 600-1500 cells/mL)
18% (normal: 60%-75%)
0.58 (normal: >1.0)
Human immune deficiency virus (HIV) viral load, p. 297
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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