Refractory hypoxia in an HIV-infected patient-a diagnostic challenge

Siddharth A. Wayangankar, Harsh Golwala, Michael S. Bronze

Research output: Contribution to journalArticle

Abstract

A 39-year-old man with HIV presented to the emergency department for evaluation of dyspnea accompanied by fever, diffuse chest discomfort, dry cough, and fatigue for past 1 week. The patient described his dyspnea as exertional progressing over 1 week to rest dyspnea. He was prescribed antiretroviral therapy but was noncompliant. He had no paroxysmal nocturnal dyspnea, orthopnea, rash, oral thrush, or diarrhea. His last record CD4+ lymphocyte count and HIV viral load were 43 cells/mm3 and 178 0000 copies/mL, respectively. Vital signs included a temperature of 101F, heart rate of 115 beats per minute, respiratory rate of 16 per minute, and pulse oxygenation of 91% on room air. Lung examination revealed decreased breath sounds bilaterally, and the remainder of the examination was unrevealing. Laboratory findings revealed leukocytosis and increased serum lactate dehydrogenase of 577 U/L (90-190 U/L), and chest radiograph showed a right lower lobe infiltrate and perihilar, bilateral interstitial infiltrates (Fig. 1A).

Original languageEnglish (US)
Pages (from-to)1322.e5-1322.e6
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number7
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

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Dyspnea
HIV
Paroxysmal Dyspnea
Thorax
Oral Candidiasis
Vital Signs
Leukocytosis
CD4 Lymphocyte Count
Respiratory Rate
Exanthema
Viral Load
L-Lactate Dehydrogenase
Cough
Fatigue
Hospital Emergency Service
Diarrhea
Fever
Heart Rate
Air
Lung

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Refractory hypoxia in an HIV-infected patient-a diagnostic challenge. / Wayangankar, Siddharth A.; Golwala, Harsh; Bronze, Michael S.

In: American Journal of Emergency Medicine, Vol. 30, No. 7, 01.01.2012, p. 1322.e5-1322.e6.

Research output: Contribution to journalArticle

Wayangankar, Siddharth A. ; Golwala, Harsh ; Bronze, Michael S. / Refractory hypoxia in an HIV-infected patient-a diagnostic challenge. In: American Journal of Emergency Medicine. 2012 ; Vol. 30, No. 7. pp. 1322.e5-1322.e6.
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