Multiple Opportunistic Infections in an 8-month-old Infant: Is it Seronegative HIV Infection?

  • Uma Nahar Saikia
  • Aman Gupta
  • Abin Koshy
  • Saniya Gupta
CLINICOPATHOLOGICAL CONFERENCE

Abstract

We describe an 8-mo-old boy who presented with acute respiratory failure following a prolonged febrile respiratory illness with features suggesting immunodeficiency.

Keywords

HIV infection Severe immunosuppression Cytomegalovirus Pneumocystis jiroveci Opportunistic infections 

Notes

Contributions

UNS prepared the pathology protocol for the manuscript and provided histopathology images; AG reviewed the literature on the subject, prepared the manuscript and was involved in patient care; AK prepared the pathology protocol for the manuscript; SG reviewed the literature on the subject. Dr. Surjit Singh, Prof and Head, Advanced Pediatrics Centre, PGIMER, Chandigarh, will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

None.

References

  1. 1.
    Enormous Gains, Persistent Challenges. In: Global AIDS Update. 2016. Available at: http://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016. Accessed 18 July 2016.
  2. 2.
    Number of children (<15 years) receiving ART globally, and by WHO region, 2000-2015. In: Children receiving ART by WHO region, 2000-2015. Available at: www.who.int/hiv/data/pedartregions2016.png?ua=1. Accessed 25 Aug 2016.
  3. 3.
    Role of CD4+ T lymphocytes in Disease Progression. In: National Guidelines for Enumeration of CD4. 2015. Available at: http://naco.gov.in/upload/2015%20MSLNS/CD4Guidelines.pdf. Accessed 25 Aug 2016.
  4. 4.
    Opportunistic Infections in HIV Infected Children. In: Pediatric Antiretroviral Therapy (ART) Guidelines. 2013. Available at: http://naco.gov.in/upload/2014%20mslns/CST/Pediatric_14-03-2014.pdf. Accessed 25 Aug 2016.
  5. 5.
    Huang L, Hecht FM, Stansell JD, Montanti R, Hadley WK, Hopewell PC. Suspected pneumocystis carinii pneumonia with a negative induced sputum examination: is early bronchoscopy useful? Am J Respir Crit Care Med. 1995;151:1866–71.CrossRefPubMedGoogle Scholar
  6. 6.
    Larsen HH, Huang L, Kovacs JA, et al. A prospective, blinded study of quantitative touch-down polymerase chain reaction using oral-wash samples for diagnosis of pneumocystis pneumonia in HIV infected patients. J Infect Dis. 2004;189:1679–83.CrossRefPubMedGoogle Scholar
  7. 7.
    Mylonakis E, Paliou M, Lally M, Flanigan TP, Rich JD. Laboratory testing for infection with the human immunodeficiency virus: established and novel approaches. Am J Med. 2000;109:568–76.CrossRefPubMedGoogle Scholar
  8. 8.
    Quinonez JM, Begue RE, Steele RW. HIV seronegativity in an infant with the acquired immunodeficiency syndrome. South Med J. 1998;91:879–81.PubMedGoogle Scholar
  9. 9.
    Chin BS, Lee SH, Kim GJ, Kee MK, Suh SD, Kim SS. Early identification of seronegative human immunodeficiency virus type 1 infection with severe presentation. J Clin Microbiol. 2007;45:1659–62.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Spivak AM, Brennan T, O’Connell K, et al. A case of seronegative HIV-1 infection. J Infect Dis. 2010;201:341–5.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Zouhair S, Roussin-Bretagne S, Moreau A, et al. Group o human immunodeficiency virus type 1 infection that escaped detection in two immmunoassays. J Clin Microbiol. 2006;44:662–5.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Loussert-Ajaka I, Ly TD, Chaix ML, et al. HIV-1/HIV-2 seronegativity in HIV-1 subtype O infected patients. Lancet. 1994;343:1393–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Hare CB, Pappalardo BL, Busch MP, et al. Seroreversion in subjects receiving antiretroviral therapy during acute/early HIV infection. Clin Infect Dis. 2006;42:700–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Quijano G, Siminovich M, Drut R. Histopathologic findings in the lymphoid and reticuloendothelial system in pediatric HIV infection: a post-mortem study. Pediatr Pathol Lab Med. 1997;17:845–56.PubMedGoogle Scholar
  15. 15.
    De Rossi A, Giaquinto C, Del Mistro A, Zamarchi R, Chieco-Bianchi L. Onset of HIV-1 antibody production after highly active antiretroviral therapy in a seronegative HIV-1-infected child. AIDS. 2000;14:1284–6.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Uma Nahar Saikia
    • 1
  • Aman Gupta
    • 2
  • Abin Koshy
    • 1
  • Saniya Gupta
    • 2
  1. 1.Department of HistopathologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Allergy Immunology Unit, Advanced Pediatrics CentrePostgraduate Institute of Medical Education and ResearchChandigarhIndia

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