IDCases . Co-infection with Coronavirus Disease 2019, previously undiagnosed Human Immunodeficiency Virus, Pneumocystis jirovecii pneumonia and Cytomegalovirus pneumonitis, with possible Immune Reconstitution Inflammatory Syndrome

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IDCases


. 2021 May 7;e01153.
doi: 10.1016/j.idcr.2021.e01153. Online ahead of print.
Co-infection with Coronavirus Disease 2019, previously undiagnosed Human Immunodeficiency Virus, Pneumocystis jirovecii pneumonia and Cytomegalovirus pneumonitis, with possible Immune Reconstitution Inflammatory Syndrome


Elisabeth A Merchant ¹ , Kristen Flint ² , Dan H Barouch ^{1 3} , Barbra M Blair ¹



Affiliations

• PMID: 33977081
• PMCID: PMC8103711
• DOI: 10.1016/j.idcr.2021.e01153

Abstract

Background: Case reports, case series and cohort studies have been published describing the clinical course and outcomes of people living with human immunodeficiency virus (PLWH) who contract coronavirus disease 2019 (COVID-19) pneumonia. However, the majority of the published work focuses on patients with well-controlled human immunodeficiency virus (HIV) on antiretroviral therapy (ART).
Case presentation: We present a case of a new diagnosis of HIV with Acquired Immune Deficiency Syndrome (AIDS) made simultaneously to diagnosis of COVID-19, with co-infection with pneumocystis jirovecii pneumonia (PJP) and possible cytomegalovirus (CMV) pneumonitis. The patient decompensated following initiation of ART, suggestive of possible immune reconstitution inflammatory syndrome (IRIS).
Conclusions: This case illustrates the importance of maintaining a high suspicion for HIV/AIDS in patients with risk factors. Additionally, this case raises the possibility that IRIS may develop in the setting of ART initiation in patients with COVID-19.

Keywords: AIDS; COVID-19; HIV; IRIS; PJP.