kpmle2
Forum Guru
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An HIV-positive 33-year-old man who refuses
antiretroviral therapy presents to the ED complaining
of a 6-week history of fever, cough,
and night sweats. His current CD4+ count is
46/mm3 and his viral load is 54,000/mL. X-ray
of the chest reveals hilar lymphadenopathy
and bilateral infiltrates. A complement fixation
test reveals a titer of 1:128. His physician suspects
coccidioidomycosis. Which of the following
would be an appropriate treatment regimen?
(A) Intravenous amphotericin B followed by
2 months of oral itraconazole
(B) Intravenous vancomycin for 2 months
(C) Intravenous vancomycin for 14 days
(D) Oral itraconazole for 2 weeks
(E) Supportive care only; the disease is selflimited
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| xak235
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"A"
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| yukti_5
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d
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| docnit
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A
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| lampard
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A
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| drms
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A
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| cingulate
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A , I.v amphotrcin B followed by itraconazole for prophylaxis Bcz CD4 = 46
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| ngaybinhyen
Forum Guru
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 It should be A
coccidioidomycosis, especially disseminated one in severely immonocompromised individual should be started on IV Amphotericine B followed by Itraconazole.
However, primary pulmonary form in non-immunocompromised person would be self-limited
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| kpmle2
Forum Guru
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Posts: 512
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Yes Ans is A. Intravenous amphotericin B followed by
2 months of oral itraconazole
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| ngaybinhyen
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Posts: 657
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many thanks
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