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Abstract: The patient was treated for suspected pneumonia due to chronic cough and fever, but his symptoms never subsided, so he came to our hospital for treatment. Combined with the patient’s long-term unexplained fever and other symptoms, as well as the comprehensive judgment that the patient had had high-risk sexual behavior, the diagnosis of AIDS was finally confirmed after a series of tests. After 2 weeks, the patient’s viral load decreased significantly, the thrush symptoms subsided, and the inflammation in the lungs was significantly absorbed.
Basic information】Male, 35 years old
Disease Type】AIDS
Hospital】Wuhan University Central South Hospital
Date of Consultation】April 2021
Treatment plan】Medication (compound chlorhexidine with gargle, compound sulfamethoxazole tablets, methylprednisolone tablets, lamivudine tablets, etc.)
Treatment period】Hospitalization for 2 weeks
Effectiveness】Viral load has been significantly reduced, thrush symptoms are relieved, and lung inflammation is significantly absorbed.
I. Initial consultation
Patient Xiao Li is a 35-year-old male. When we first saw the patient, he reported that he had been suffering from fever and cough for more than a month, and at first he thought it was a common cold. After communication with the patient, preliminary examination of the patient revealed that there were white patches of curdled milk in the oral mucosa, while CT chest examination and sputum culture examination revealed inflammation in the lungs, and the sputum culture results showed that the infecting organism was Pneumocystis carinii. Combining the above symptoms and the patient’s personal experience, we suspected an opportunistic infection caused by AIDS. The patient was then given HIV-1/2 antibody test, HIV nucleic acid test and CD4+ T lymphocyte test, and the diagnosis of AIDS was confirmed.
II. Treatment history
Since the patient had an opportunistic infection caused by AIDS and was in a period of coexistence of multiple diseases at this time, the patient was given symptomatic treatment, which mainly included the following.
1. Treatment for Pneumocystis pneumonia: Considering that the patient had respiratory distress, oxygen therapy was arranged for the patient to improve the patient’s hypoxic symptoms. For Pneumocystis pneumonia, patients were given compound sulfamethoxazole tablets and methylprednisolone tablets to control the infection and suppress lung inflammation.
2, for the treatment of thrush: the disease is mainly caused by Candida infection, so its treatment is mainly antifungal treatment, so the patient is prescribed compound chlorhexidine rinse, so that he can rinse his mouth on time, and pay attention to the maintenance of oral health.
3. Treatment for AIDS: AIDS is a disease caused by human immunodeficiency virus infection, and the patient needs to be treated with antiviral drugs, so the patient was given lamivudine tablets, propofol tenofovir fumarate tablets and other drugs for treatment to inhibit the reproduction of the virus and control the further development of the disease.
III. Treatment effect
After a series of active treatment, the patient’s Pneumocystis carinii pneumonia gradually improved, and his symptoms such as fever, cough and dyspnea disappeared. The patient’s thrush has also improved due to the regular use of medication, and the patient’s oral mucous membrane white spots have disappeared. In addition, for AIDS, after 2 weeks of medication, HIV-1/2 antibody test, HIV nucleic acid test and CD4+ T lymphocyte test were performed again, and the results showed that the viral load in the patient’s body had decreased significantly and the level of CD4+ T lymphocytes had increased, indicating that the disease was now under control. In view of the above, and in view of the patient’s good personal condition, he was discharged from the hospital after 2 weeks of hospitalization, and continued to take medication and to have regular follow-ups.
IV. Notes
We are glad that, after a series of treatments, the patient’s symptoms such as Pneumocystis pneumonia and thrush were effectively managed, and his AIDS condition was controlled, and he successfully met the discharge requirements. However, since the patient’s disease cannot be effectively cured at present, the patient still needs to continue taking oral medication after discharge and needs to pay attention to the following.
1. patients still need to take medication regularly after discharge from the hospital, and must not stop taking medication on their own, for example, they can set an alarm clock to remind themselves to take medication, or if they need to go out, they can buy dispensing boxes and carry them with them for easy access to medication.
2. Patients may experience adverse reactions such as nausea and vomiting after taking the medication for a long time, which are normal side effects during the treatment period, and should never give up taking the medication because of this. It is recommended that patients develop an incentive mechanism for themselves, such as rewarding themselves for taking the medication once, in order to improve medication adherence.
3. If symptoms such as fever, diarrhea, headache, etc. occur, you should go to the hospital in time to clarify whether there are opportunistic infections and complications such as tumors, so that doctors can deal with them in time.
V. Personal insight
AIDS is an immunodeficiency disease that can lead to various degrees of immune deficiency, which can lead to various opportunistic infections and tumors, and eventually death due to various serious infections and tumors. However, AIDS is not an uncontrollable disease. As long as the patient is treated symptomatically, the specific pathogenic bacteria of the infection is found, and appropriate medications are applied, the patient’s infection can be controlled. As in the case of the patient in this article, multiple pathogenic infections were treated with medications and eventually the disease was effectively controlled.
There are many antiviral drugs available for AIDS patients to control their disease. These drugs are more effective and can reduce the viral load in the patient’s body, and if detected early and treated promptly, the patient’s survival time is longer. Since high-risk sex is the main way of HIV transmission, once you have high-risk sex, you should immediately seek blocking medication at a nearby hospital.