CASE SPOTLIGHT

The Addis Clinic connects physicians to patients – that is the foundation of our work. We want to give you a look inside a case our physicians consult on.

A 34-year-old female from Kenya with an HIV-positive diagnosis came to the clinic complaining of several months of worsening respiratory symptoms, weight loss, fevers and hand clubbing.

She mentioned having for quite some time increased shortness of breath and episodes of recurrent upper respiratory infections. The attending physician reported extensive amounts of mucus that was whitish and foamy, the highest volume in the morning, without blood. In three month she had lost 15kg (33lbs) and was treated before with 7 days of amoxicillin (antibiotic), which improved the symptoms for only a little while.

The patient also experienced intermittent nausea, vomiting, and abdominal pain which worsened by movement and pulmonary hypertension (high blood pressure). After her mucus tested positive for bacterial infection and yeast it was questioned if the patient had a chronic inflammatory lung disease in combination with Haemophilus influenza, a bacteria that can cause serious infections. In western countries, children get the Hib vaccine to prevent this type of infection.

In a lot of countries, including Kenya, the majority of the population is vaccinated through the Hib vaccine against this type of infection. But especially people with a compromised Immunsystem, like in our case HIV, are at increased risk for developing H. influenza disease.

The consulting physician in the U.S. could pinpoint his recommendation to treat the bacterial infection with a medication combination of antifungal and antibiotics since all the symptoms could be explained by a chronic pulmonary fungal infection.