RESUMO
The case history of a HIV patient with a pulmonary infect of Rhodococcus equi is presented. He recovered after prolonged treatment with antibiotics and lobectomy. The Rhodococcus equi infection was the presenting symptom of his impaired immune status caused by HIV infection.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Infecções por HIV/diagnóstico , Pneumonia Bacteriana/microbiologia , Rhodococcus equi/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/terapia , Adulto , Antibacterianos , Antivirais/uso terapêutico , Quimioterapia Combinada/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1/isolamento & purificação , Humanos , Masculino , Pneumonectomia , Pneumonia Bacteriana/diagnóstico por imagem , Pneumonia Bacteriana/terapia , Radiografia , Resultado do TratamentoRESUMO
BACKGROUND: Disulfiram is a substance often used to treat alcohol dependency. The agent may be effective when used as supportive therapy. Disulfiram causes an accumulation of acetaldehyde when alcohol is consumed, which results in unpleasant sensations such as warmth, nausea, vomiting and headache. CASE DESCRIPTION: A patient was brought into the emergency ward with a suspected alcohol intoxication. As it turned out, she had experienced a severe disulfiram-ethanol reaction which had led to hypotensive shock; extensive abnormalities were seen on the ECG. The patient was admitted to the intensive care unit. High-dose norepinephrine treatment was needed to bring the blood pressure back to normal. The use of disulfiram was only discovered at a later stage. CONCLUSION: In rare cases, a disulfiram-ethanol reaction can lead to life-threatening situations. Descriptions of toxicity at acetaldehyde levels of 5 mg/l are found in the literature. In this article, we describe a life-threatening reaction which developed at a level between only 2.3-3.0 mg/l. This case shows that the provision of information on a patient's use of medications and adequate communication are just as important as toxicological screening in the laboratory.