Case presentation: a 35 year old man with cystic pneumocystis pneumonia, cerebro-ocular lymphoma and recurrent bacteraemia.

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Case presentation: a 35 year old man with cystic pneumocystis pneumonia, cerebro-ocular lymphoma and recurrent bacteraemia.

Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:27 (abstract no. TC-3). Unique Identifier : AIDSLINE ASHM5/94348948
Paterson DL; Allworth AM; Hospital Brisbane, Australia.

Abstract: A 35 year old man HIV antibody positive since 1986 presented in February 1993 with pleuritic chest pain haemoptysis and dyspnoea. His past history included syphilis, bacillary angiomatosis, Kaposi's sarcoma and CMV retinitis. His CD4 lymphocyte count was 70 x 10(6)/L. He was on didanosine and monthly nebulised Pentamidine. Physical examination revealed a low-grade fever (37.8 degrees C) and a left pleural rub. CXR revealed marked cystic changes in the left lower lobe and a small apical pneumothorax. Pneumocystis carinii was isolated from an induced sputum sample. In view of a Bactrim allergy, he was treated with intravenous Pentamidine for 3 weeks. He made a dramatic improvement with total clearing of the cystic changes over a number of weeks. He re-presented in May 1993 with dysphasia and poor balance. MRI of his head showed multiple low intensity lesions in both cerebral hemispheres. The lesions increased in number despite 2 weeks of anti-Toxoplasma treatment delivered by a peripherally inserted central catheter (PICC). A stereotactic cerebral biopsy was performed revealing a high-grade B cell lymphoma. He was treated with radiotherapy (40 Gy in 15 fractions) with good clinical response. However the vision in his left eye deteriorated due to orbital recurrence of lymphoma. The patient had 2 bacteraemic episodes with Gram negative organisms during his illness. These were with Serratia marcescens and then Acaligenes denitrificans. Cystic pneumonia due to Pneumocystis carinii and the spectrum of bacteraemic illnesses seen in HIV-infected people will be reviewed.

Keywords: Adult AIDS-Related Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY Bacteremia/*DIAGNOSIS Brain Neoplasms/*DIAGNOSIS Case Report Cysts/*DIAGNOSIS/DRUG THERAPY Human Lung Diseases/*DIAGNOSIS/DRUG THERAPY Lymphoma, AIDS-Related/*DIAGNOSIS Male Orbital Neoplasms/*DIAGNOSIS Pentamidine/THERAPEUTIC USE Pneumonia, Pneumocystis carinii/*DIAGNOSIS/DRUG THERAPY ABSTRACT
941230
M94C4279

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