Emma, a seven-month-old infant has been suffering with diarrhea, thrush, and weight loss over the previous two months. E
Posted: Mon Jul 11, 2022 2:26 pm
Emma, a seven-month-old infant has been suffering with diarrhea,thrush, and weight loss over the previous two months. Emma wasborn a healthy infant. She grew and normally developed during thefirst five months after birth. She received routine immunizationwith diphtheria, pertussis, tetanus and Hib vaccines at 2, 4, and 6months of age without complications. Emma was seen on a numberof occasions by the family's doctor over the past two months.Previous blood work did not reveal anything noteworthy.Her mother brought her into the clinic today as she wasincreasingly concerned for her. Her physical examinationrevealed an elevated temperature (38°C), pneumonia, a rapid heartand respiratory rate, diarrhea, a diaper rash and thrush. New bloodwork was ordered. Her CD4+ T cells were below the normalrange, her CD8+ T cells were in the normal range. The levelsof her serum immunoglobulins were in the normal range however shedid not have antibodies to tetanus toxin despite having beenvaccinated. Her blood cultures were negative for microbes but herfeces contained Cryptosporidium and her mouth had Candida albicansgrowth. Noting the depressed ratio of CD4+ T cells/ CD8+ T cells,the doctor ordered additional tests for HIV infection; and askedthe parents to go for tests. Emma's results indicated that she waspositive for HIV-1 and that she had a viral load of HIV that was120,000 copies of HIV-RNA per ml of plasma. Both parents(Thomas and Lana) were found to be positive for HIV-1 despitethe absence of any outward signs of the infection. At the initialparental interview, no risk factors for HIV infection had beenidentified. However, on re-questioning, Thomas admitted tointravenous drug use in his late teens. He also reported having hadshingles soon after returning from his honeymoon a few yearsago.
Why did Emma have no microbial infections during her firstfive months after birth?
A Complement passed in utero from the mother to the fetus
B Immunoglobulins passed in utero from the mother to thefetus
C T cells passed in utero from the mother to the fetus
D B cells passed in utero from the mother to the fetus
What kinds of microbes are most likely to cause infection inpatients with HIV? (list 4)
What are "shingles", and what might explain their occurrence inthe father's case?
Emma's condition, prompted Thomas to have some lab tests toassess his own immunological functions. Thomas's CD4+ T cell countwas 170 cells per mm3 and his CD8+ T cell count was 550 cells permm3. His HIV load was >100,000 copies of viral RNA/mLplasma.
What diagnosis would you give Thomas and why?
Why did Emma have no microbial infections during her firstfive months after birth?
A Complement passed in utero from the mother to the fetus
B Immunoglobulins passed in utero from the mother to thefetus
C T cells passed in utero from the mother to the fetus
D B cells passed in utero from the mother to the fetus
What kinds of microbes are most likely to cause infection inpatients with HIV? (list 4)
What are "shingles", and what might explain their occurrence inthe father's case?
Emma's condition, prompted Thomas to have some lab tests toassess his own immunological functions. Thomas's CD4+ T cell countwas 170 cells per mm3 and his CD8+ T cell count was 550 cells permm3. His HIV load was >100,000 copies of viral RNA/mLplasma.
What diagnosis would you give Thomas and why?