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Office of Education
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InterviewHe has been followed as an outpatient on a B.I.D. regimen of two nucleoside reverse transcriptase inhibitors (D4T and 3TC) and a protease inhibitor (nelfinavir) with a stable but detectable HIV viral load (25,000 copies) and a CD4 count of 190 three months ago. He states that he rarely takes all his pills every day. He has continued to actively use drugs, but has had no active clinical problems until about 3 weeks ago when he began to have a dry cough. This continued for about 2 weeks and only occasionally was associated with clear sputum production, without any change in sputum color or hemoptysis. He then began to note the onset of some dyspnea on exertion which now has progressed to SOB at rest. Over the past 3 days he has noted the onset of fever to 102 that has persisted despite Tylenol, so he came to the ER. Past medical history is notable for an episode of S. aureus TV endocarditis three years ago that was successfully treated with antibiotics. He admits to having multiple sexual partners, and was incarcerated last year for selling cocaine.  |
