[Adult-hlh-mas] Possible HLH Case Parkland [securemail]
DHEEPA.SEKAR at phhs.org
Sun Aug 5 15:07:46 CDT 2018
Alpha, U (no name given on admission and patient somewhat disoriented. Family now here and involved in care)
36 yo Honduran man presented with 1 month of fatigue and night sweats. No prior known medical history, found to have HIV and disseminated histo on this admission. Course has rapidly progressed, now intubated with ARDS and in septic shock on escalating pressor requirement. Currently on amphotericin for histo as well as RIPE (pending AFB smears) and Bactrim IV for possible PCP. Also with +RPR and treating for secondary syphilis (macules on palms).
Workup thus far:
thrombocytopenia (20, no other signs of hemolysis), anemia
HIV +, CD4 13. histo ag positive. fungal comp fix pending. fungal culture pending.
MTB CPR neg. AFB 2/3 neg
PGY3 Internal Medicine
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