20 May 2008
Severe unexplained HIV seronegative immune suppression (SUHIS) with invasive aspergillosis and candidiasis
Omotayo Olatinwo, Chinedu Ivonye, Uma Jamched, Madiha Khan, Francene Warner, Eric FlenaughAm J Case Rep 2008; 9:280-284 :: ID: 858184
Abstract
Background: HIV/AIDS infection is typically associated with a low CD4 count. In general CD4 count is a marker of clinical progression and management of the disease. HIV/AIDS is also associated with CD4/CD8 ratio of less than 1 and hypergammaglobulinemia. Emerging reports of CD4 lymphopenia in the absence of evidence of HIV -1 or HIV -2 infections led to a new clinical entity called Severe Unexplained HIV- seronegative immune suppression( SUHIS) by the World Health Organization. We report a case of SUHIS in a 30 year old man with Invasive Aspergillosis and Candidiasis.
Case Report: A 30 year-old-male with no significant past medical history presented with worsening right sided chest pain, productive cough, and shortness of breath of two weeks duration. He was incarcerated few months prior to presentation where he had a negative PPD and HIV test. He reported a 15 pack year history of cigarette smoking in addition to smoking “rolled up tissue paper” in jail. After initial investigations, he was found to have right cavitary lung lesions secondary to invasive aspergillosis, oropharyngeal candidiasis and a very low CD4 count which was suggestive of immunosuppression. Further investigations confirmed his diagnosis of SUHIS. He was treated with fluconazole for candidiasis and amphotericin/voriconazole for aspergillosis.
Conclusions: SUHIS is defi ned exclusively by CD4 count of less than 300/mcL or < 20% of total T cells on two occasions, in the absence of HIV infection and the presence of opportunistic infection, indicative of cellular immune defi ciency.
Keywords: Aspergillosis, CD4 depletion, CD4/CD8 ratio, AIDS/HIV, immunosuppresion
In Press
12 Feb 2024 : Case report
Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PETAm J Case Rep In Press; DOI: 10.12659/AJCR.941169
12 Feb 2024 : Case report
Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942839
13 Feb 2024 : Case report
Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel HematomaAm J Case Rep In Press; DOI: 10.12659/AJCR.943519
13 Feb 2024 : Case report
Hemorrhagic Presentation in Primary Central Nervous System Lymphoma: A Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.942951
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250