A 10-year-old male with vertically transmitted HIV infection diagnosed at 2 years of age.
She had a history of poor adherence to several proposed treatment regimens, and her mother had also rejected hypersensitivity.
She had been hospitalized several times due to intercurrent diseases caused by common and opportunistic microorganisms.
She was admitted for a 5-day history of abdominal pain, accompanied by fever up to 38.5°C and generalized maculopapular rash.
At the time of admission, in addition to rash, secondary malnutrition, poor general condition, cervical lymphadenopathy, moist rales in both lung fields, dental caries and purulent otorrhea to the left were found.
At that time he had a viral load (CV) of 95,000 copies/ml and CD4 lymphocytes of 26 cells/mm3.
Antibiotic therapy was initiated, however, at 48 h the fever persisted and intense headache, vomiting, photophobia and acusophobia were added.
A skull CT was performed which was normal; the cytochemical analysis of CSF: glucose 0.43 g/l, protein 1.15 gr/l, cellularity: 5 Chinese leukocytes/mm3; direct microscopic examination (tin).
The patient was treated with amphotericin B deoxycholate i.v. for 21 days, followed by oral fluconazole in a manatee plan.
There was clinical improvement and the CSF study at 21 days was normal with negative culture.
She was discharged after 33 days and one month of evolution already showed weight gain and good general condition.
Susceptibility testing showed no mutations associated with resistance, so treatment with AZT, lamivudine (3TC) and lopinavir/ritonavir was started.
