Difficulty breathing in a 2-month-old infant

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Prepared by...
Virat Sirisanthana, M.D.
Department of Pediatrics, Faculty of Medicine, Chiang Mai University
More information of  the illness.........
Family History : Her mother awared of her HIV-infected status at the time of anti-natal care, but she refused zidovudine (AZT) protocol for fear of  the cost. The infant did not receive any Pneumocystis carinii pneumonia prophylaxis.
Other Laboratory Findings :
Serology : HIV-Ab : positive
Serum Enzymes: Lactate dehydrogenase: 1,300 units/L
Blood culture : no growth for bacteria and fungus
Course in the hospital:
With respiratory support and anti Pneumocystis carinii therapy, she gradually improved and could be extubated in 7 days.
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Final Diagnosis: Pneumocystis carinii pneumonia in HIV-infected infant
Points to learn :
1. The most common severe opportunistic infection in infants born to HIV-infected mothers (although their HIV-infected status have not yet been known) is Pneumocystis carinii pneumonia.
2. Antinatal, perinatal and postnatal zidovudine regimen could decrease HIV transmission from mothers to infants.
3. The zidovudine regimen is "free of charge" to every Thai HIV-positive pregnant woman.
4. Pneumocystis carinii pneumonia prophylaxis should be given to every infant born to HIV-infected mother until the infected status is established or until the age of 6-12 month old.
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