Abstract Coinfections involving more than one opportunistic pathogen, although uncommon, pose significant diagnostic and therapeutic challenges. In this report, we present the case of a young woman with advanced human immunodeficiency virus (HIV) disease who developed concurrent pulmonary infections with Pneumocystis jirovecii and Cryptococcus spp . She was referred to our tertiary care hospital in a state of severe emaciation, CD4 count of 17 copies/mL, progressive shortness of breath, and suspected P. jirovecii pneumonia that failed initial treatment. The patient’s hospital course was aggressive and ultimately resulted in a fatal clinical outcome. This case underscores the critical need to investigate multiple causes of pneumonia in severely immunosuppressed individuals. Since coinfections can complicate diagnosis, worsen the clinical course, and increase mortality, we feel that this aspect should receive attention by internists managing advanced HIV disease. These coinfections may otherwise be overlooked by clinicians following protocols based on single-infection guidelines. Documenting dual opportunistic infections signals an emerging public health issue or a change in the spectrum of diseases affecting HIV-positive populations.
Mukherjee et al. (Sat,) studied this question.
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