A case of HIV infection in a child associated with ethics of patients in medicine (case report)

Abstract

Background. Patients with a recurrent infection that is resistant to traditional therapy are a clinical challenge in pediatrics. This recurrent pathology is often concealing another disease. In addition, timely diagnosis and administration of etiotropic therapy are often delayed when medical ethics have been deviated, namely, when medical history collection was dubious. Materials and methods. The authors describe a clinical case of human immunodeficiency virus (HIV) infection in a 4-year-old girl with recurrent oral candidiasis and anemia. The case was detected in the Ternopil region. Results. The child had hyperthermic syndrome and enanthema of the oral mucosa, refractory to treatment for one month. The child was hospitalized. This case is distinguished by the fact that during medical history collection, the father did not disclose his HIV positive status. The child was resistant to traditional stomatitis therapy during pre-hospital and hospital stages. Microbial inoculation of the oral mucosa revealed C.albicans (abundant growth). After CD4 lymphocyte number was detected (CD3 — 43.8 %, MCL — 712; CD4 — 0.6 %, MCL — 10), a child was diagnosed with stage 3 HIV infection and severe immunosuppression. In this case, concealing of HIV infection resulted in a delayed diagnosis and prescription of a specific therapy. The reliability of the information that is provided by the parents is directly related to the faster diagnosis and administration of antiretroviral therapy. Conclusions. In case when the therapeutic effect of traditional treatment for opportunistic infections is absent, doctors should consider possible HIV infection. Low public trust in physicians is a factor impeding timely diagnosis and prescription of etiotropic therapy.

Keywords

• children
• hiv infection
• сandidiasis
• мedical еthics