• Gerrit Herpertz, Matthias Haerting, and Oliver Radke.
• Klinik für Anästhesie und chirurgische Intensivmedizin, Klinikum Bremerhaven-Reinkenheide, Bremerhaven.
• Dtsch. Med. Wochenschr. 2022 Oct 1; 147 (20): 1330-1335.

AnamnesisWe saw a previously healthy 30-year-old Southeast-Asian sailor with progredient coughing and fever.ExaminationWe found an atypical pneumonia along with a positive HIV-test. We performed a bronchial lavage and further diagnostics for opportunistic infections. The lab work showed a viral load of 3340 000 copies/ml and a CD4-cell-count of 36/µl.DiagnosisHIV late presenter in CDC stadium C3 with Pneumocystis jirovecii and CMV pneumonia.TherapyWe treated with Meropenem, Moxifloxacin, Cotrimoxazol, Ganciclovir and Genvoya.Clinical CourseDue to a cardio-pulmonal deterioration invasive ventilation was necessary. In the end the patient died of multi organ failure twelve days after admission despite intensive care, hemodialysis and prone positioning.ConclusionThis case demonstrates the difficulties in the pharmacotherapy and with drug interactions in a HIV late presenter with multi organ failure. Consultation and advice of the hospital pharmacy and the antibiotic stewardship team was vital for treating this patient. In the end cases like the portrayed should be treated in specialized clinics.Thieme. All rights reserved.

35 keywords...

hide…