{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T07:13:12Z","timestamp":1693552392343},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Anamnese\u2002Wir sahen einen zuvor gesunden 30-j\u00e4hrigen s\u00fcdostasiatischen Seemann mit progredientem Husten und Fieber.\u200a<\/jats:p><jats:p>\n          Untersuchungen\u2002Wir fanden eine atypische Pneumonie bei positivem HIV-Test. Im Verlauf erfolgten eine Bronchiallavage und weitere Untersuchungen zur Diagnostik etwaiger opportunistischer Infektionen. Das Labor zeigte eine Viruslast von 3340\u200a000 Kopien\/ml und eine CD4-Zellzahl von 36\/\u00b5l.<\/jats:p><jats:p>\n          Diagnose\u2002HIV-\u201eLate Presenter\u201c im CDC-Stadium C3 mit Pneumocystis jirovecii und CMV-Pneumonie.<\/jats:p><jats:p>\n          Therapie\u2002Wir therapierten mit Meropenem, Moxifloxacin, Cotrimoxazol, Ganciclovir und Genvoya.<\/jats:p><jats:p>\n          Verlauf\u2002Es kam zu einer fulminanten kardiopulmonalen Verschlechterung, sodass die maschinelle Beatmung notwendig wurde. Letztendlich verstarb der Patient 12 Tage nach Aufnahme, trotz Intensivtherapie mit Dialyse und kinetischer Lagerungstherapie, am Multiorganversagen.<\/jats:p><jats:p>\n          Folgerung\u2002Dieser Fall zeigt die Schwierigkeiten der Pharmakotherapie und der Medikamenten-Interaktionen bei der Behandlung eines HIV-Late Presenter mit Multiorganversagen. Die Beratung durch die Krankenhausapotheke und das Antibiotic Stewardship Team war wesentlich f\u00fcr die Behandlung des Patienten. Letztendlich sollten solche Patienten in spezialisierten Zentren behandelt werden.<\/jats:p>","DOI":"10.1055\/a-1911-4567","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T22:36:36Z","timestamp":1664922996000},"page":"1330-1335","source":"Crossref","is-referenced-by-count":1,"title":["Fallbericht \u00fcber die Erstdiagnose einer HIV-Erkrankung eines jungen Seemanns durch 2 AIDS-definierende Erkrankungen mit letalem Intensivverlauf"],"prefix":"10.1055","volume":"147","author":[{"given":"Gerrit","family":"Herpertz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesie und chirurgische Intensivmedizin, Klinikum Bremerhaven-Reinkenheide, Bremerhaven"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Haerting","sequence":"additional","affiliation":[{"name":"Krankenhausapotheke, Klinikum Bremerhaven-Reinkenheide, Bremerhaven"},{"name":"Antibiotic Stewardship Team, Klinikum Bremerhaven-Reinkenheide, Bremerhaven"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Radke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesie und chirurgische Intensivmedizin, Klinikum Bremerhaven-Reinkenheide, Bremerhaven"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.33675\/GM\/2021\/47\/1","article-title":"HIV in Deutschland 2020 Erfassung der SARS-CoV-2-PCR-Testzahlen","author":"Robert Koch-Institut","year":"2021","journal-title":"Epidemiologisches Bulletin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1093\/infdis\/jiv235","article-title":"Mortality Risk After AIDS-Defining Opportunistic Illness Among HIV-Infected Persons--San Francisco, 1981-2012","volume":"212","author":"K Djawe","year":"2015","journal-title":"J Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00063-020-00757-1","article-title":"Die HIV-Infektion auf der Intensivstation","volume":"117","author":"J Ankert","year":"2022","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1055\/a-1665-6762","article-title":"HIV-Erstdiagnosen in Deutschland im Jahr 2014 \u2013 eine regionale Analyse","author":"T B Schleenvoigt","year":"2022","journal-title":"Gesundheitswesen"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1111\/hiv.12403","article-title":"The late-presenting HIV-infected patient 30 years after the introduction of HIV testing: spectrum of opportunistic diseases and missed opportunities for early diagnosis","volume":"18","author":"D Tominski","year":"2017","journal-title":"HIV Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1093\/labmed\/24.5.286","article-title":"1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults: Centers for Disease Control and Prevention","volume":"24","author":"K Castro","year":"1993","journal-title":"Lab Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1093\/infdis\/jiw086","article-title":"Opportunistic Diseases During HIV Infection-Things Aren\u2019t What They Used to Be, or Are They?","volume":"214","author":"H Furrer","year":"2016","journal-title":"J Infect Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1093\/infdis\/jiw085","article-title":"Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010","volume":"214","author":"K Buchacz","year":"2016","journal-title":"J Infect Dis"},{"key":"ref12","doi-asserted-by":"crossref","DOI":"10.1515\/9783110738896","volume-title":"Innere Medizin 2021","author":"G Herold","year":"2021"},{"key":"ref13","volume-title":"HIV 2020\/2021","author":"C A Hoff","year":"2020"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s002280050420","article-title":"The area under the plasma concentration-time curve for oral midazolam is 400-fold larger during treatment with itraconazole than with rifampicin","volume":"54","author":"J T Backman","year":"1998","journal-title":"European journal of clinical pharmacology"}],"container-title":["DMW - 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