C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND最新文献

Outcomes of SARS-CoV-2 Infection in Solid Organ Transplant Recipients 实体器官移植受者SARS-CoV-2感染的结果

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4953

K. Nada, E. Polychronopoulo, G. Sharma, A. Duarte

引用次数: 0

Hypoxic Respiratory Failure Due to Pneumocystis Jiroveci and Cytomegalovirus Co-Infection in a Severely Immunocompromised Patient 严重免疫功能低下患者合并肺囊虫和巨细胞病毒感染致缺氧呼吸衰竭1例

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4944

B. Chinai, D. Kim

{"title":"Hypoxic Respiratory Failure Due to Pneumocystis Jiroveci and Cytomegalovirus Co-Infection in a Severely Immunocompromised Patient","authors":"B. Chinai, D. Kim","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4944","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4944","url":null,"abstract":"Introduction:Immunocompromised individuals, such as those with HIV and low CD4 counts, are at increased risk for opportunistic infections. Although uncommon, these patients can be infected with multiple organisms, making diagnosis and management challenging for clinicians. Mortality remains high, as the data on initiating and adjusting antimicrobials when there is concern for co-infection is lacking. We present a case of Pneumocystis jiroveci (PCP) and cytomegalovirus (CMV) coinfection resulting in severe hypoxic respiratory failure and death. Case Report:A 38-year-old male with no past medical history presented with fever, dyspnea, and nonproductive cough. Vital signs were notable for a fever of 102.3°F, respiratory rate of 24, and oxygen saturation of 77% on room air. Physical examination revealed an ill-appearing male with bilateral rhonchi who became dyspneic with minimal conversation. Laboratory studies were significant for an elevated c-reactive protein, erythrocyte sedimentation rate, ferritin and lactate dehydrogenase. CT chest demonstrated bilateral ground glass opacities with multifocal consolidations. The patient was admitted for hypoxic respiratory failure secondary to suspected COVID pneumonia, despite negative testing. By hospital day 4, the patient had shown little improvement. Further work-up revealed that he was HIV positive with a CD4 count of 5, so he was empirically started on oral trimethoprim-sulfamethoxazole (TMPSMX) for presumed PCP pneumonia. On hospital day 9, the patient underwent endotracheal intubation for worsening hypoxia and subsequent bronchoscopy for further evaluation. PCP PCR confirmed the diagnosis, and the patient was transitioned to intravenous TMP-SMX. Still with minimal improvement, micafungin was added as potential salvage therapy. After 12 days of TMPSMX, treatment was changed to clindamycin/primaquine. CMV PCR from the bronchoalveolar lavage fluid came back positive at this time, so ganciclovir was added to the regimen. Despite multiple antimicrobials, the patient continued to decline. He was deemed not to be a candidate for ECMO given his profoundly immunocompromised status and ultimately died. Discussion:This case highlights the difficulties clinicians have in managing severely immunocompromised patients who worsen despite appropriate care. Little data exists providing guidelines on when to change to second and/or third-line agents in treating PCP pneumonia. Additionally, further studies need to be completed to delineate in whom empiric antimicrobials should be initiated early when co-infection is a possibility. ECMO may serve a purpose in this patient population given that lung rest is necessary to allow healing, but only a few cases of its use exist at this time.","PeriodicalId":303021,"journal":{"name":"C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125841627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Rare Case of Concurrent Chronic Pulmonary Aspergillosis and Pulmonary Coccidioidomycosis Infection in an Immunocompromised Host 在免疫功能低下的宿主中并发慢性肺曲霉病和肺球虫菌病的罕见病例

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4956

S. Singh, H. Singh, E. Gill, M. Fayed

引用次数: 0

Cytokine-Based Predictive Model of Pulmonary Function Trajectories in People Living with HIV 基于细胞因子的HIV感染者肺功能轨迹预测模型

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4937

Ioannis Konstantinidis, T. Lovelace, R. DeSensi, P. Benos, K. Kunisaki, C. Rinaldo, A. Morris, S. Nouraie

引用次数: 0

Outcomes of Patients with Systemic Sclerosis Admitted for Aspiration Pneumonitis Analysis of the National Inpatient Sample 系统性硬化症吸入性肺炎住院患者的结局分析

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4940

J. Pescatore, M. Rivera, W. Davis, E. Akuna, I. Asemota, J. Sanchez, S. Kannayiram

引用次数: 0

HIV Infection Upregulates EMAP II in Lungs of Humanized Mice HIV感染上调人源化小鼠肺部的EMAP II

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4958

R. Elmergawy, A. Schneider, E. Suarez, C. Matthias, S. Almodovar

引用次数: 0

Pseudomembranous Tracheobronchitis Due to Pseudomonas Aeruginosa in a Patient with Cystic Fibrosis During Lung Transplant Surveillance Bronchoscopy 肺移植监测期间囊性纤维化患者由铜绿假单胞菌引起的假膜性气管支气管炎

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4950

K. Bruening, M. Matta, B. Young, R. Schilz, S. Avasarala, T. Panchabhai

引用次数: 0

Evolving COVID-19 Outcomes Among Lung Transplant Recipients During the Second Surge in New York City, a Single Center Experience 在纽约市第二次高峰期间肺移植受者中不断变化的COVID-19结果，单中心体验

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4947

K. Laothamatas, J. Hum, L. Benvenuto, L. Shah, H. S. Grewal, M. Pereira, J. Scheffert, M. Carroll, M. Nolan, G. Reilly, P. Lemaitre, B. Stanifer, J. Sonett, F. D'Ovidio, H. Robbins, S. Arcasoy

引用次数: 0

Disseminated Verruconis Gallopava Infection in a Patient with History of Renal Transplant and Hemophagocytic Lymphohistiocytosis (HLH) 肾移植合并嗜血球性淋巴组织细胞增多症患者弥散性加洛巴瓦疣感染1例

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4955

R. Joshi, M. Narkhede

引用次数: 0

Disseminated Exophiala Infection in an Immunocompromised Patient 免疫功能低下患者弥散性外滴感染

C107. IMMUNOCOMPROMISED LUNG DISEASE, HIV, AND BEYOND Pub Date : 2022-05-01 DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a4952

P. Shin, A. M. Gonzales, Kotovich Le

引用次数: 0