Misdiagnosed Analysis of Acquired Immune Deficiency Syndrome Complicated with Pneumocystis Pneumonia

SHEN Lan-chao; ZHANG Qing; YANG Shu-feng; XUE Le-yang

doi:10.3969/j.issn.1002-3429.2016.09.023

Abstract：Objective To analyze the clinical characteristics of acquired immune deficiency syndrome ( AIDS) com-plicated with pneumocystis pneumonia ( PCP) and its misdiagnosis causes. Methods Clinical data of 1 patient with AIDS and PCP admitted to our hospital was retrospectively analyzed. Results The patient was admitted for fever, asthma and cough for 10 d, in other hospitals check pulmonary CT scan showed diffuse pulmonary lesions. The patient had a history of contact with poultry, and therefore was highly suspected as having pathogenic avian influenza on admission. In our hospital, the pa-tient was treated with respiratory isolation, conventional anti infection and antiviral therapy with poor effect. Repeated checks showed that the virus nucleic acid of H5N1, H7N9, influenza A and influenza B were negative. Review of the chest CT showed pulmonary diffuse ground glass-like change. Questioning of the medical history revealed that the patient had the high-risk sexual life history, the anti HIV was positive;CD4 + T lymphocyte count was 37/μl, and therefore the patient was diag-nosed as having AIDS complicated with PCP. Treatments by Compound Sulfamethoxazole, Prednisone tablets and anti-virus for 14 d, the symptoms of the patient were significantly improved and discharged from hospital. Followed up for 12 months, the patient did not feel discomfort. Conclusion Early symptoms of AIDS are vary, and tend to be misdiagnosed. Patients with clinical symptoms of diffuse pulmonary interstitial changes, and rapidly tend to respiratory failure, when conventional anti-vi-rus, and anti-infection treatment prove to be ineffective, clinicians should be highly suspected as having AIDS with PCP.