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Table 2 Summary of main clinical, laboratory and imaging findings from patient 2

From: Disseminated rhodococcus equi infection in HIV infection despite highly active antiretroviral therapy

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
  1. Notes. VL viral load; i.v. intravenous; p.o. per os; CNS central nervous system; MRI magnetic resonance imaging