An Incıdentally Detected Case of AIDS Admitted with the Clinical Presentation of COVID-19 During the Pandemic
covid-19 - hiv/aids - pandemic - pneumocystis jirovecii
Pneumocystis pneumonia (PCP) is a serious opportunistic infection caused by the fungus Pneumocystis jirovecii.However, the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the patients, following therecognition of pneumonia cases of unknown etiology on December 31, 2019, in Wuhan, China revealed a new type ofcoronavirus. The disease caused by that virus has subsequently been named COVID-19 (Coronavirus disease 2019) bythe World Health Organization. In clinical practice, we encounter fever, shortness of breath, and radiological findingscompatible with pneumonic infiltration in the bilateral lung parenchyma in both infections (PCP and COVID-19). As ofMay 11, 2020, the COVID-19 outbreak affected 198 countries and about 4.239.167 people on five continents. The WorldHealth Organization declared it a pandemic on March 20, 2020. During the pandemic, COVID-19 should be consideredfirst in every patient presented with fever and respiratory distress, and further examinations should be carried out. A22-year-old male patient admitted with the complaints of fever and respiratory distress for two days during this period.On physical examination, his fever was 38,3°C with fine bilateral rales at lung auscultation. Results of the laboratorytesting were as follows: the blood glucose level 100 mg/dl, serum creatinine level 0,59 mg/dL, AST 46 U/L, ALT 17 U/L,LDH 1102 U/L, CRP 62 mg/l, D-dimer 954 mg/L, leucocytes 12.410 /mm3 (87,6% neutrophils; 6,8% lymphocytes),hemoglobin 11.9 g/dL and platelet count 258000 /mm3. Thorax computed tomography (CT) demonstrated patched areaswith frosted glass density in both lungs, more prominently on the left side, and in the lower lobes. The patient wasadmitted with a preliminary diagnosis of COVID-19, and then the Anti-HIV test was positive. Based on clinical, laboratory,and radiological examinations, we administered both COVID-19 and PCP treatments to our case. He was finallydischarged after recovery. During the pandemic, not only SARS-COV-2, but also other infectious agents that may causelung infections should not be ignored, and they all should be considered in the differential diagnosis.