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[耶氏肺孢子菌、SARS-CoV-2感染与晚期HIV感染的同时诊断及良好转归]

[Simultaneous diagnosis and favorable evolution of infection with Pneumocystis jirovecii, SARS-CoV-2 and advanced HIV].

作者信息

Larzábal Francisco J, Vilela Andrés, Brusca Silvia, Saluzzi Irene, Ghergo Gisela E, Angiono María Antonela

机构信息

Servicio de Clínica Médica, Hospital Dalmacio Vélez Sarsfield, Buenos Aires, Argentina. E-mail:

Servicio de Clínica Médica, Hospital Dalmacio Vélez Sarsfield, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2020;80(5):554-556.

Abstract

SARS-CoV-2 causes the disease named COVID-19, which emerged in Wuhan, China, in December 2019 and developed into the current pandemic. The manifestations of SARS-CoV-2 infection are highly variable. The worst outcomes are usually associated with advanced age and known risk factors. Among these, it would be reasonable to consider conditions compromising the immune system, particularly the immunodeficiency associated to HIV. To date, however, there is no evidence of HIV infection worsening the evolution and prognosis of COVID-19. Pneumocystis jirovecii (previously-P. carinii) pneumonia, is a fungal disease that most commonly affects immunocompromised persons and can be life-threatening. Typically, patients at risk are those with any underlying condition altering host immunity. We present the case of a middle-aged woman with Raynaud's syndrome who was admitted with pneumonia. During hospitalization she was simultaneously diagnosed with infection by HIV, COVID-19 and P. jirovecci. The patient evolved favorably upon empirical treatment without requiring invasive maneuvers or ventilatory support. Outpatient follow-up after hospital discharge was uneventful.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发了名为2019冠状病毒病(COVID-19)的疾病,该病于2019年12月在中国武汉出现,并发展成为当前的大流行疾病。SARS-CoV-2感染的表现高度多变。最严重的后果通常与高龄和已知风险因素有关。其中,考虑损害免疫系统的状况,特别是与艾滋病毒相关的免疫缺陷,是合理的。然而,迄今为止,没有证据表明艾滋病毒感染会使COVID-19的病程和预后恶化。耶氏肺孢子菌(以前称为卡氏肺孢子菌)肺炎是一种真菌病,最常影响免疫功能低下者,可能危及生命。通常,有任何改变宿主免疫力的基础疾病的患者属于高危人群。我们报告一例患有雷诺综合征的中年女性因肺炎入院的病例。住院期间,她同时被诊断出感染了艾滋病毒、COVID-19和耶氏肺孢子菌。该患者经经验性治疗后病情好转,无需进行侵入性操作或通气支持。出院后门诊随访情况良好。

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