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Case Reports
. 2019 Sep 26;11(9):e5767.
doi: 10.7759/cureus.5767.

Unexpected Diagnosis

Gauravpal S Gill  1 , Rukma R Govindu  2 , Ragai Fouda  3 , Hussam M Ammar  1
Affiliations
Case Reports

Unexpected Diagnosis

Gauravpal S Gill et al. Cureus. .

Abstract

A 74-year-old man presented to the ER with an eight-month history of shortness of breath, cough, anorexia, and weight loss. He had emigrated from sub-Saharan African to the USA, where he was diagnosed and treated for coronary artery disease, heart failure, and stroke; was hospitalized several times; and underwent hernia surgery. Despite the complex care that he received in the USA for many years, the diagnosis of AIDS was continually missed for years, and the patient was eventually diagnosed at the age of 74.

Keywords: aids; diagnostic momentum; diagnostic parsimony; hicham’s dictum.; hiv; limited english proficiency; occam’s razor; pneumocystis pneumonia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Portable anteroposterior chest radiography.
Cephalization (black arrows), alveolar and reticular opacities (white arrows).
Figure 2
Figure 2. Portable anteroposterior chest radiography.
Interval progression with development of extensive bilateral alveolar opacities (black arrows).
Figure 3
Figure 3. Contrast-enhanced CT of chest.
Bilateral alveolar opacities ( black arrow ), pneumatoceles ( white arrows ), and bilateral small pleural effusions.
See this image and copyright information in PMC

References

    1. U.S. Statistics. [Sep;2018 ];https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics 2017
    1. Vital signs: human immunodeficiency virus testing and diagnosis delays—United States. Dailey AF, Hoots BE, Hall HI, et al. Morb Mortal Wkly Rep. 2017;66:1300–1306. - PMC - PubMed
    1. HIV screening in the health care setting: status, barriers, and potential solutions. Rizza SA, MacGowan RJ, Purcell DW, Branson BM, Temesgen Z. Mayo Clin Proc. 2012;87:915–924. - PMC - PubMed
    1. Achieving quality in clinical decision making: cognitive strategies and detection of bias. Croskerry P. Acad Emerg Med. 2002;9:1184–1204. - PubMed
    1. Tuberculosis trends--United States, 2014. Scott C, Kirking HL, Jeffries C, Price SF, Pratt R. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6410a2.htm Morb Mortal Wkly Rep. 2015;64:265–269. - PMC - PubMed

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