Department of Medicine, Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY.
Department of Pediatrics, Division of Pediatric Critical Care, Albany Medical Center, Albany, NY.
Chest. 2022 Jul;162(1):e9-e13. doi: 10.1016/j.chest.2022.02.022.
A 28-year-old man with a history of congenital HIV sought treatment at the ED with a chief symptom of generalized malaise and confusion of 3 days' duration. He had mild dyspnea, but no respiratory distress, and he reported no fever, chest pain, or headache. We were unable to obtain past medical, family, or social history because of encephalopathy and we had no available contact person. Review of the patient's medical record revealed he made an initial clinic visit to the Department of Pediatric Infectious Disease 5 years previously. At the time of that visit, CD4 count was 250 cells/mm and no known complications of HIV were documented. He was prescribed Stribild (elvitegravir-cobicistat-emtricitabine-tenofovir disoproxil fumarate) and darunavir; however, pharmacy records revealed he did not fill the prescriptions. He underwent no further clinic follow-up examinations. He grew up in California and moved to upstate New York 5 years previously.
一位 28 岁的男子，自幼感染 HIV，因全身不适和意识混乱 3 天到急诊就诊。他有轻度呼吸困难，但无呼吸窘迫，无发热、胸痛或头痛。由于患者有脑病，我们无法获得既往病史、家族史或社会史，也没有可联系的人员。查看患者的病历，发现他 5 年前曾首次到儿科传染病科就诊。当时 CD4 计数为 250 个细胞/毫米，无 HIV 并发症的记录。他当时被开了 Stribild（艾维雷韦/考比司他/恩曲他滨/替诺福韦艾拉酚胺富马酸盐）和达芦那韦，但药房记录显示他没有拿药。此后他没有再进行门诊随访检查。他在加利福尼亚长大，5 年前搬到了纽约州北部。
