1. A rare case of an HIV-seronegative AIDS patient with Pneumocystis jirovecii pneumonia
- Author
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Qiaofei Zheng, Youzu Xu, Jiaxi Feng, Shuangquan Yan, Zhuolin Gao, Jing Huang, and Hongguo Zhu
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,Case Report ,Disease ,Window period ,Pneumocystis carinii ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,Pneumocystis jirovecii ,lcsh:RC109-216 ,030212 general & internal medicine ,AIDS patients ,Acquired Immunodeficiency Syndrome ,HIV-seronegative ,AIDS-Related Opportunistic Infections ,biology ,business.industry ,Pneumonia, Pneumocystis ,virus diseases ,medicine.disease ,biology.organism_classification ,Pneumocystis jirovecii pneumonia ,Anti-Bacterial Agents ,CD4 Lymphocyte Count ,Treatment Outcome ,Infectious Diseases ,Immunology ,Etiology ,biology.protein ,RNA, Viral ,Antibody ,business ,Viral load - Abstract
Background As technology progresses, several highly sensitive human immunodeficiency virus (HIV) screening kits are being researched and developed to quickly and efficiently identify serum HIV antibodies within the non-window period. In individuals who are HIV-seronegative, HIV infections that are not within a window period are rare. In such cases, all antibody detection methods will fail, and misdiagnosing these patients will have catastrophic consequences. Case presentation A 22-year-old male Chinese patient with diffuse exudative lesions in both lungs and initial symptoms of cough and dyspnoea was diagnosed with Pneumocystis jirovecii pneumonia (PJP) by aetiological examination, and the patient’s plasma CD4+ T-cell count was extremely low. In China, PJP is prevalent in HIV-infected individuals. Pneumocystis jirovecii (P. jirovecii) has a high colonisation rate in patients with HIV infections. This patient was naturally suspected of being an HIV patient; however, serum HIV antibody tests were negative using both an enzyme-linked immunosorbent assay (ELISA) and a latex agglutination assay, and HIV was not detected by western blotting. Subsequently, the plasma HIV viral load was found to be extremely high on two repeated plasma HIV RNA tests, thus confirming HIV-seronegative acquired immunodeficiency syndrome (AIDS) in this patient. With administration of effective anti-P. jirovecii treatment and highly active antiretroviral therapy (HAART) after diagnosis, the patient’s disease condition was rapidly controlled. Conclusion This is the second reported case in China of an HIV-seronegative AIDS patient. Such cases are also rare worldwide. Although HIV-seronegative HIV infections are rare, AIDS should be considered in immunodeficient patients with opportunistic infections, even if the test results are HIV-seronegative. Plasma HIV RNA testing is important for such patients. Electronic supplementary material The online version of this article (10.1186/s12879-019-4143-8) contains supplementary material, which is available to authorized users.
- Published
- 2019