Archive | Case of the Month

Every month, we highlight a case that represents current questions from our clinician consultations.

Case of the Month: PEP Management and Kidney Disease

Case Summary The Clinician Consultation Center received a call from an occupational health provider caring for a physician who had just been stuck with a needle used to perform an arthrocentesis on a known HIV-positive source patient (SP). The SP was taking combination antiretroviral therapy which consisted of co-formulated abacavir/lamivudine (Epzicom®) and efavirenz (Sustiva®). The […]

Case of the Month: Exposure Management: Labor and Delivery and Breastfeeding

Case Summary The Clinician Consultation Center received a call from a nurse on labor and delivery (L&D) who was preparing to admit a woman who was actively in labor at 41 weeks gestation. From review of the chart, the patient (who is also a healthcare provider) sustained a needle-stick five to six weeks ago from […]

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Case of the Month: Considering PrEP for Sero-Discordant Couples

Case Summary The Clinician Consultation Center received a call from a primary care provider regarding a 34-year-old man who was evaluated in the emergency department three days earlier for a non-occupational exposure after the condom broke during intercourse with his HIV-positive female partner. The patient has completed three days of post-exposure prophylaxis (PEP) medications without […]

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Case of the Month: Simplifying ARV Regimens, Pt. II

Case Summary This case is continued from a previous case. See Part I here. The Clinician Consultation Center received a call from a new infectious diseases provider in Texas about a 50 year-old patient who was newly referred to her for care. The patient was diagnosed with HIV in 1990, and has been on multiple […]

Case of the Month: Simplifying ARV Regimens, Pt. I

Case Summary The Clinician Consultation Center received a call from a new infectious diseases provider in Texas about a 50-year-old patient who was newly referred to her for care. The patient was diagnosed with HIV in 1990, and has been on multiple antiretroviral therapy (ART) regimens since then. His current regimen, consists of abacavir, co-formulated […]

Case of the Month: Cervical Cancer Screening In HIV-Positive Women

Case Summary A nurse practitioner calls about a 61-year-old HIV-positive woman. The patient was diagnosed in 2002, and is currently virologically suppressed on combination ART. She had a total hysterectomy in 2000 due to persistent dysplasia (no further details are available) and subsequently had three yearly negative vaginal Pap tests. She has not had any […]

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Case of the Month: Needlestick PEP in a Correctional Setting

Case Summary A physician calls about a correctional officer who stuck himself with a sewing needle while going through an inmate’s personal belongings. His finger had a shallow injury and there was no visible blood on the needle. The officer is immunized against HBV but does not know if he responded. The source person is […]

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Case of the Month: HIV and TB Co-Infection Management

Case Summary A physician called for advice about a 47-year-old male heterosexual patient who’d been newly diagnosed with HIV. The patient had presented with a gastric mass on a CT scan, and was Acid-Fast Bacilli- (AFB) positive on biopsy, indicating possible Tuberculosis (TB) infection. The patient was being treated for both Mycobacterium Avium Complex (MAC) […]

Case of the Month: Needlesticks, HIV+ Source Patients, and PEP

Case Summary A physician who specializes in occupational health called regarding a registered nurse (RN) who sustained a needlestick 36 hours ago. She was drawing blood with a butterfly needle from a source patient who is known to be HIV antibody-positive. The injury was shallow and it was unknown if the needle was visibly bloody […]

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Case of the Month: Possible Acute HIV Infection

Case Summary A doctor called the HIV/AIDS Management Service to ask about an 18-year-old male who had been diagnosed with syphilis and was presenting to clinic with low-grade fever, pharyngitis, and cervical adenopathy. The patient had had unprotected receptive anal intercourse with another male three to four weeks prior to the time of the call. […]