Management of Stage-4 HIV with Cerebral Toxoplasmosis Coinfection and SIADH Complication

Laksono, Pandu and Oktavia, Erlin and Putri, Hidayati Adi and Herawati, Fauna (2024) Management of Stage-4 HIV with Cerebral Toxoplasmosis Coinfection and SIADH Complication. Majalah Kedokteran Bandung (MKB)/Bandung Medical Journal, 56 (3). pp. 221-227. ISSN 0126-074X ; E-ISSN 2338-6223

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Abstract

HIV/AIDS stage 4 is the stage where the HIV/AIDS patients have low immunity protection against infections, which can led to coinfections and complications. This case report presented an evaluation of the diagnosis and treatment of an HIV/AIDS stage 4 patient with cerebral toxoplasmosis coinfection and SIADH complications. A man (47 years, 35 kg), married with two children, complaining of weakness, nausea, vomiting, weight loss, and low appetite. Sodium level were measured, showing a 117 mg/dL level that continued to decrease throughout the patient's treatment. Five days later, the patient lost his consciousness with a GCS score of 224, indicating severe brain injury, and was diagnosed with cerebral toxoplasmosis based on the result of head CT-SCAN with contrast. On day 6, the patient was tested positive for HIV and diagnosed with stage 4 with an absolute CD4 count of 4 cells/μl. Therapy was provided by giving pyrimethamine-clindamycin therapy for cerebral toxoplasmosis, followed by Tenofovir, Lamivudine, and Evafirenz as antiretroviral therapy. Treatment for hyponatremia was done by administration of 3% NaCl and tolvaptan. The patient started experiencing an improvement in consciousness after the 10th day of medication, and sodium levels fluctuated throughout the treatments. Patient was discharged after 15 days with clinical improvements.

Item Type:	Article
Uncontrolled Keywords:	HIV, acquired immunodeficiency syndrome, cerebral toxoplasmosis, inappropriate ADH syndrome, anti-retroviral agents, antiparasitic agents, hypertonic sodium chloride solution
Subjects:	R Medicine > RS Pharmacy and materia medica
Divisions:	Faculty of Pharmacy > Department of Pharmacy
Depositing User:	Ester Sri W. 196039
Date Deposited:	28 Oct 2024 07:54
Last Modified:	28 Oct 2024 07:54
URI:	http://repository.ubaya.ac.id/id/eprint/47357

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