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February 2014 NEWSLETTER
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2014
February
February 2014 Newsletter
GRAND ROUNDS
A 5 month old boy presented with recurrent fever, cough and cold for 2 months. There is no contact with TB. Birth was uneventful and he is immunized till date. He was on exclusive breast feeds. On examination, he was febrile, had tachypnea (respiratory rate = 86/min) with subcostal and intercostal retractions and had hepatosplenomegaly. Other systems were normal. In view of recurrent infections with hepatosplenomegaly and pneumonia, an underlying immunodeficiency was suspected. Mother’s HIV ELISA was positive. The child’s investigations showed:
• Hemoglobin = 8.6 gm/dl
• WBC = 3,800/cumm (67% polymorphs, 28% lymphocytes)
• Platelet = 18,000/cumm
• Chest X-Ray = Bilateral basal haziness
• ABG = Hypoxia
The child was treated with Inj Ceftriaxone and Amikacin but did not respond. An ID consult was asked on Day 4 of hospitalization but the child died in the next hour. A post mortem BAL was advised.
What could be the likely infection in this child?
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HIV GRAND ROUNDS
A 32 years old HIV infected pregnant female (G2P2L1) presented at 36 weeks of pregnancy for deciding neonatal antiretroviral (ARV) prophylaxis. Her HIV viral load at 34 weeks of gestation was undetectable and she was on antiretroviral therapy (ART) consisting ....
HIV IN CHILDREN APPS