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A 30 years old body who affected with HIV has started to cough and dyspnea since 7 days ago, in CXRAY infiltrative interstitial patern was seen bilaterally, and in ABG, PaO2=55 mmHg, what is the appropriate remedy before diagnosis become certained?
A. TMP/SMX plus steroids
B. ceftazidim plus amikacin
C. vancomycin plus metronidazole
D. anit TB drugs


None. This guy needs Oxygen at 100%; consider intubation if hypercarbia. Before doing so get sputum and blood for cultures, gram, and other analysis. If empiric antibiotic therapy is consider, I'd go with option B- ceftazidim plus amikacin.


isn't that PCP?


Oopps! yeah, It looks like pneumocystis now that you mention. By the way, why the steroids? I need to study this.


Steroids are indicated in "severe" PCP (pO2<70, A-a gradiant>35)


wink A is the correct answer

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