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M9550150.TXT
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1995-03-04
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Document 0150
DOCN M9550150
TI [Pulmonary mucormycosis in an HIV-infected patient]
DT 9505
AU Harloff KJ; Stoehr A; Wasmuth R; Plettenberg A; Harten J; Medizinische
Abteilung, Allgemeines Krankenhaus St. Georg,; Hamburg.
SO Dtsch Med Wochenschr. 1995 Jan 27;120(4):94-8. Unique Identifier :
AIDSLINE MED/95136878
AB A 51-year-old man, known to have chronic-aggressive hepatitis B, HIV
infection and exertional dyspnoea, was hospitalized because of acute
physical deterioration, cough with whitish exudate and dyspnoea at rest.
Despite a CD4/CD8 ratio of 0.16 no prophylactic measures against
Pneumocystis carinii had been taken. On examination the lungs were
unremarkable, but the liver was enlarged and there were petechiae over
all parts of the body. Laboratory tests showed impaired liver functions
and a rise in lactate dehydrogenase activity (538 U/l). Chest radiogram
demonstrated small to very small infiltrates in the lung. As
Pneumocystis carinii pneumonia was suspected but bronchoscopy was too
risky, he was at first treated with trimethoprim/sulphamethoxazole (four
times 320/1600 mg/24 h intravenously). When this failed, he received
pentamidine (4 mg/kg, after 4 days 2 mg/kg intravenously), and finally
cefotiam (twice 2 g daily), tobramycin (three times 40 mg daily) and
corticoids (100 mg). Despite this treatment he died after 10 days from
respiratory failure. Autopsy revealed interstitial pneumonia throughout
the lung as well as focal mucor infiltrations in the wall of
middle-calibre lung veins. Mucor is a ubiquitous, facultatively
pathogenic mold fungus.
DE *AIDS-Related Opportunistic Infections Case Report Diagnosis,
Differential English Abstract Fatal Outcome Human HIV
Infections/*COMPLICATIONS Lung/MICROBIOLOGY Lung Diseases,
Fungal/*COMPLICATIONS Male Middle Age Mucormycosis/*COMPLICATIONS
Pneumonia, Pneumocystis carinii/DIAGNOSIS JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).