Abstract:
HIV-associated hemophagocytic lymphohistiocytosis (HLH) is mainly due to infections caused by viruses, fungi, and, to a lesser extent, bacteria, often with fatal results. Case presentation: A 15-year-old pediatric patient from another institution was admitted to our hospital with a fever of unknown origin (FUO). Clinical analysis and laboratory studies diagnosed HIV infection. The approach to an FUO in a patient with AIDS is much more complex due to the search for common etiologies and opportunistic infections. In this case, disseminated histoplasmosis, pulmonary tuberculosis, pneumocystosis, and ehrlichiosis were diagnosed, prompting an urgent and comprehensive approach to prevent mortality. Due to the multiple infections, HLH was triggered. An early intervention with trimethoprim (TMP)-sulfamethoxazole (SMX), liposomal amphotericin B, doxycycline, and quadruple antiphimic therapy to suppress infections, in conjunction with the early administration of HLH treatment, favored the survival of this patient.
摘要:
HIV相关性噬血细胞性淋巴组织细胞增生症(HLH)主要是由于病毒引起的感染,真菌,and,在较小程度上,细菌,往往有致命的结果。病例介绍:另一个机构的15岁儿科患者因不明原因发烧(FUO)入院。临床分析和实验室研究诊断为HIV感染。由于寻找常见的病因和机会性感染,在AIDS患者中使用FUO的方法要复杂得多。在这种情况下,播散性组织胞浆菌病,肺结核,肺孢子虫病,埃里希体病被诊断出来,促使采取紧急和全面的方法来预防死亡。由于多重感染,HLH被触发。甲氧苄啶(TMP)-磺胺甲恶唑(SMX)的早期干预,脂质体两性霉素B,多西环素,和四重抗免疫疗法来抑制感染,结合早期给予HLH治疗,有利于这个病人的生存。