Unusual Remission Of Pneumocystis Carinii Pneumonia In A Patient With The Acquired Immune Deficiency Syndrome
American Journal of Medicine 82(3 Spec No): Mar 23 1987; 645-648
View Original Source →Abstract
A case of cytomegalovirus chorioretinitis in a 30-year-old male intravenous drug user with group 4 human immunodeficiency virus type 1 (HIV-1) infection is reported. The patient was not given ganciclovir treatment and two months later the dark spots had resolved and did not recur in the subsequent 3 months. Spontaneous remission of cytomegalovirus retinitis has not been previously reported. (Permission to reproduce case report denied by publisher.)
Case Details
Personal Characteristics
33-year-old black man, history of intravenous use of heroin and cocaine
Clinical Characteristics
Dysphagia, pharyngeal candidiasis, bilateral pleuritic chest pains, shortness of breath, bilateral pulmonary infiltrates, fevers, chills, weight loss, prominent candidal pharyngitis, bilateral scattered rales on chest auscultation, progressive infiltrates on chest radiography, p. Carinii in biopsy specimen, a small cotton-wool spot in the left fundus, restrictive pulmonary disease, arterial desaturation with minimal exercise, bilateral lower lobe infiltrates, drug-related leukopenia, adrenal insufficiency
Remission Characteristics
Resolution of chest pains, fevers, and shortness of breath, nearly complete clearing of infiltrates on chest radiography, symptom free and normal chest radiographic findings after treatment
Treatment & Mechanisms
Proposed Remission Mechanisms
Fluctuations in the degree of immunocompetence
Clinical Treatment
Nystatin oral suspension, penicillin vk, cefaclor, erythromycin intravenously, oral trimethoprim/sulfamethoxazole, pentamidine isethionate
Non-Clinical Treatment
Daily ingestions of fresh garlic and multivitamins
Additional Notes
The patient left the hospital against medical advice after receiving only two doses of oral trimethoprim/sulfamethoxazole. He resorted to non-clinical treatment with fresh garlic and multivitamins. He had a cardiopulmonary arrest and could not be resuscitated two weeks after returning home from treatment for adrenal insufficiency.