An Unfortunate Outcome of a Preventable Diagnosis: A Case Report

Abstract

The human immunodeficiency virus (HIV) is one of the sexually transmitted infections with the greatest impact on the patient’s life. Early diagnosis is essential to promptly initiate antiretroviral therapy and avoid the disease’s progression.
We present the case of a 60-year-old woman with a three-month history of epigastric pain, ageusia and weight loss of 9%. She performed blood tests, upper and lower digestive endoscopy, and chest X-ray, which revealed a large hiatal hernia and mild lymphopenia. A month later, she developed dyspnea, temporospatial confusion, and a change in speech and went to the emergency department where she was diagnosed with HIV Infection. During hospitalization, further tests revealed a Pneumocystis jirovecci infection and the presence of primary lymphoma of the central nervous system, both acquired immunodeficiency syndrome (AIDS)-defining diseases.
With this case we aim to alert for the importance of HIV diagnosis in patients with constitutional symptoms and its screening not only in at-high-risk populations but also, at least once a lifetime, in adults aged between 18 and 64 without risk factors.