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رابعة : حالة هضمية 1


رابعة : حالة هضمية 1


حالة سريرية

الوصف الكامل Background

A 24-year-old patient who is known to be infected with HIV-1 presents with a 2-week history of intermittent bloody diarrhea, urgency, abdominal pain, and malaise. Stool culture for enteropathogenic organisms is negative, and analysis for ova and parasites is similarly unrevealing. The patient is taking no medication. The diarrheal symptoms do not respond to a course of ciprofloxacin. Colonoscopic examination reveals multiple areas of ulceration and mucosal erosion. Biopsy reveals the presence of cells containing a large, densely staining nucleus and abundant intracytoplasmic inclusions. The most appropriate therapy for this patient is

A. acyclovir
B. clarithromycin
C. ganciclovir
D. pentamidine
E. pyrimethamine

explain your answer....

by

First of all we should consider that our pt here is infected with HIV-1 and this make him at a high risk of infection..
then we should know that those pts who r infected with HIV,are infected with nonopportunistic pathogens..
now in this case all what we have is directing us to GI infections..
+since we did the biopsy which is typical to CMV cellular effects we can just say it is CMV colitis.However it is rare to see this infection in patients with HIV infection or AIDS,as eMedicine said"3-5% of patients with HIV infection or AIDS."
all in all ,administer ganciclovir it would help>>
Green Wave's picture
Green Wave

Quote:
First of all we should consider that our pt here is infected with HIV-1 and this make him at a high risk of infection..
then we should know that those pts who r infected with HIV,are infected with nonopportunistic pathogens..
now in this case all what we have is directing us to GI infections..
+since we did the biopsy which is typical to CMV cellular effects we can just say it is CMV colitis.However it is rare to see this infection in patients with HIV infection or AIDS,as eMedicine said"3-5% of patients with HIV infection or AIDS."
all in all ,administer ganciclovir it would help>>

100%
that was exactly my explanation
thank you Mo2nes.....betdal m3allemna

Vince Carter


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