Disseminated histoplasmosis complicated by concurrent opportunistic infections in a person living with HIV (PLHIV) — The need for infectious disease high dependency units in the United Kingdom

Abstract

We describe an immunocompromised HIV patient with disseminated histoplasmosis, cerebral toxoplasmosis, Pneumocystis jirovecii pneumonia (PJP) with cytomegalovirus (CMV) and Human Herpes virus 8 (HHV8) viraemia complicated by severe thrombocytopenia and hypocalcaemia. During a prolonged inpatient admission at our infectious disease (ID) high care unit (HCU), he represented a diagnostic challenge and management dilemma involving a variety of medical specialties. We aim to explore the difficulties surrounding the diagnosis and management of disseminated histoplasmosis especially in view of other concurrent opportunistic infections (OIs). We aim to elaborate on how this rare case provided new insight into the management of multiple OIs in a severely immunocompromised HIV individual and why we need specialist ID high dependency units.

Keywords

• Human immunodeficiency virus
• HIV
• Patient living with HIV
• PLHIV
• AIDS
• Histoplasmosis