PDF(Pubmed)
Abstract：
We present the case of a young male who was diagnosed with HIV in 2012. However, his initiation of antiretroviral therapy (ART) was delayed until 2018 due to issues related to his acceptance and acknowledgment of the disease. In April 2021, the patient presented with hemoptysis, shortness of breath, and constitutional symptoms. Initial extensive workup for tuberculosis (TB) and other respiratory pathogens returned negative. Despite this, he was treated for smear-negative pulmonary TB and pneumocystis pneumonia (PCP) and was subsequently discharged. He then had recurrent hospital admissions due to worsening respiratory symptoms, with short intervals between recovery and recurrence. Each admission saw an increase in his oxygen requirements. Throughout these hospitalizations, tests for coronavirus disease 2019 (COVID-19) were consistently negative. TB and PCP treatment continued throughout his admissions. Despite various treatments, his condition continued to deteriorate. A DNA polymerase chain reaction (DNA PCR) test for cytomegalovirus (CMV) was eventually conducted. Unfortunately, the patient succumbed to progressive respiratory failure, and the CMV DNA PCR returned positive a week after his death. In the era of COVID-19, this case underscores the importance of early diagnosis and timely antiviral treatment.
摘要：
我们介绍了2012年被诊断患有HIV的年轻男性的案例。然而,由于与接受和确认疾病相关的问题,他开始抗逆转录病毒治疗(ART)的时间被推迟至2018年.2021年4月，患者出现咯血，呼吸急促,和体质症状。结核病（TB）和其他呼吸道病原体的初始广泛检查为阴性。尽管如此,他接受了涂片阴性肺结核和肺囊虫肺炎(PCP)的治疗,随后出院.随后，由于呼吸道症状恶化，他反复住院，恢复和复发之间的时间间隔很短。每次入院都增加了他的氧气需求。在这些住院期间，2019年冠状病毒病（COVID-19）检测一直呈阴性。结核病和PCP治疗在他的整个入院期间继续进行。尽管有各种治疗方法,他的病情继续恶化。最终进行巨细胞病毒(CMV)的DNA聚合酶链反应(DNAPCR)测试。不幸的是,病人死于进行性呼吸衰竭,CMVDNAPCR在他死后一周恢复为阳性。在COVID-19时代，该病例强调了早期诊断和及时抗病毒治疗的重要性。
