Abstract
Introduction: A male patient with high fever and respiratory distress visited a town clinic and was diagnosed to be suffering from AIDS (by CDC criteria).
Case presentation: He was 28yr old and had donated blood 3yr earlier, when an anti-HIV test was negative. His chest XP showed interstitial pneumonia. His WBC was 22, 500/μl and CD4 was 35/μl. He had normocytic anemia (Hb 10.5g/dl). Anti HIV test was positive and his HIVRNA level was 1.6×105 copies/liter. He was transferred to the Hokkaido University Hospital and treated with AZT, ddI and IDV for AIDS and many drugs for pneumonia, but treatment was in vain, and he died 6 months later. An autopsy revealed desquamative interstitial pneumonia, cerebral hemorrhage, fatty liver and pericarditits.
Discussion: It was shown that this patient progressed to AIDS in a short period of time. There are several factors relating to disease progression. In this case, the subtype of HIV was B and E, and the virus load was rather large.
Conclusion: This case report suggests the importance of recognition that there could be AIDS patients in ordinary clinic settings. On the other hand, it has been shown that donor interviews at blood centers to prevent window-phase infection of HIV is very important, although actual window-phase infection has been reported only once so far.
