Publications by authors named "Shilla Zachariah"

3 Publications

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Pneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/L and Atovaquone Prophylaxis.

Case Rep Infect Dis 2020 12;2020:8532780. Epub 2020 Jul 12.

Department of Internal Medicine, Reading Hospital-Tower Health System, West Reading, PA, USA.

We describe a rare case of pneumonia (PCP) in a heterosexual man with a pertinent medical history of well-controlled human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) and PCP prophylaxis with atovaquone. The patient presented with recurrent shortness of breath, worsening malaise, and fever, following treatment for hypersensitivity pneumonitis one month prior, including a twenty-four-day course of 40 milligrams daily glucocorticoid with taper. However, transbronchial biopsies, lavage, and cytology from prior admission were inconclusive. The patient refused video-assisted thoracic surgery (VATS) at that time. Upon readmission, bronchoscopy with right VATS and lung biopsy were performed. Grocott's methenamine silver stain of right lung biopsy was positive for . This case is a rare example of PCP in a patient with a normal CD4 count (>487 cells/L) and a low viral load (<20 copies/mL) despite PCP prophylactic antibiotics in the setting of recent iatrogenic immunosuppression.
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July 2020