Table 2 Summary of main clinical, laboratory and imaging findings from patient 2
Onset of symptoms (date) | Presenting symptoms | Site of R. equi infection (diagnostic technique) | CD 4 + cells, HIV-1 RNA (VL) | HAART | Treatment | Duration |
|---|---|---|---|---|---|---|
May 2005 | fever, cough, dyspnea | lung (culture of sputum, chest X-ray, chest high resolution CT scan) | 133 cells/μl, VL: 40,700 copies/ml | lamivudine, tenofovir, efavirenz | induction (i.v.): rifampicin 600 mg qd, levofloxacin 500 mg qd, azythromicin 500 mg qd maintenance (p.o.): levofloxacin 500 mg qd azytromicin 500 mg qd | induction: 2 weeks maintenance: 8 weeks |
September 2009 | weight loss, fever, subcutaneous nodule in the right thigh | subcutaneous thigh tissue (culture of granuloma, MRI, needle aspirate); colon (colonoscopy with biopsy) | 90 cells/μl VL: 78,650 copies/ml | emtricitabine, tenofovir, atazanavir | azythromicin i.v. 500 mg qd, levofloxacin i.v. 750 mg qd, ryfampicin i.v. 600 mg qd, switched to rifabutin p.o. 150 mg q48h at beginning of HAART | 8 weeks |
November 2009 | fever, ascites, diarrhoea | colon, peritoneum, abdominal lymph nodes, lung (total body CT and PET scan) | 59 cells/μl, VL: 778 copies/ml | emtricitabine, tenofovir, darunavir/r | induction (i.v.): imipenem 1 g q6h amikacin 1 g qd maintenance (p.o.): azythromicin 500 mg qd, levofloxacin 750 mg qd | induction: 3 weeks maintenance: 10 weeks |
March 2010 | fever, abdominal pain and intestinal bleeding | disseminated infection (blood culture); colon (CT scan and histological examination of surgically removed colonic tissue); lung (biopsy); subcutaneous thigh tissue (culture of needle aspirate, MRI); skin. | 62 cells/μl VL < 50 copies/ml | emtricitabine, tenofovir, darunavir/r | surgery induction (i.v.): imipenem 500 mg q6h, switched to ertapenem 1 g qd after 7 weeks, levofloxacin 750 mg qd, vancomicin 500 mg bid, azythromicin 500 mg qd maintenance (p.o.): azythromicin 500 mg qd, rifabutin 150 mg q48h | induction: 14 weeks maintenance: 8 weeks |
August 2010 | headache | CNS (brain CT scan and MRI) | 74 cells/μl VL < 50 copies/ml | emtricitabine, tenofovir, darunavir/r | induction (i.v.): imipenem 500 mg q6h, amikacin 1 g qd maintenance (i.v.): meropenem 1 g q8h, azythromicin 500 mg qd, switched to ertapenem 1 g qd after 10 weeks | induction: 3 weeks maintenance: 10 weeks |