pxx445-453.

30-PENICILLIOSIS (-confirm by 2lab tests-) + "Slow Progressor"

Each patient is unique... Doctors should always think that nearly all is possible...

Male, 15 years old. infected by mother. Very very very difficult social background. Orphan. In charge from grand mother. Skin problem seems to be very old. (since he is 7 years old (?)). CD4 when diagnosis was done the first time: 700(!?!)

When I met the kid, CD4 were 290. Penicilliosis was the unique symptom but the kid was looking like 10 years old (he was 15).

After difficult negotiation, the help of local hospital and school, he finally accepted to go to hospital for a cure of ampho (14 days) and since that he accepted to take regularly (?) itraconazole. Skin become normal after one week of ampho...

3 weeks after the begin of treatment, new cd4 test: 370...

The kid still do not receive ARV. Medical authorities prefer to wait as long as possible since everybody is afraid of bad compliance and rapid resistance.. Better to wait as log as possible.

The kid is what we call "SLOW PROGRESSOR" and will soon reach puberty without ARV... meaning other kind of problems in perspective... About "slow progressor", you can find article on the web. But what is strange here is the penicillium marnefei infection with very high CD4 and severe but not evoluting symptoms since years.

 

See '05-bedsore"