Professional paper
https://doi.org/10.2478/10004-1254-62-2011-2071
Undiagnosed AIDS in Patients with Progressive Dyspnoea: An Occupational Risk for Healthcare Workers in Croatia
Kornelija Miše
; Clinical Department for Pulmonary Diseases, Split University Hospital, Split, Croatia
Maja Vučković
; Clinical Department for Pulmonary Diseases, Split University Hospital, Split, Croatia
Anamarija Jurčev-Savičević
; Teaching Public Health Institute of Split, Split, Croatia
Ivan Gudelj
; Clinical Department for Pulmonary Diseases, Split University Hospital, Split, Croatia
Irena Perić
; Clinical Department for Pulmonary Diseases, Split University Hospital, Split, Croatia
Joško Miše
; Medicine School on University of Zagreb, Zagreb, Croatia
Abstract
Pulmonary diseases are well documented and diverse in many patients with HIV in clinical stages 3 and 4. It is not unusual that these patients, most of whom do not know that they are already HIV-infected, are fi rst examined and hospitalised by respiratory medicine specialists. While HIV-infection is relatively simple to diagnose if accompanied by advanced clinical manifestations and is regularly checked in patients with increased risk, this is not the case in low-risk patients, particularly in countries with low-level HIV epidemic
and therefore low index of suspicion. Regular examination involves a series of tests, often including bronchoscopy with transbronchal lung biopsy in order to identify an interstitial lung disease and/or
progressive dyspnoea. It is not uncommon that patients provide false or incomplete information about their lifestyle, which can mislead the clinician. At this point, HIV-infection is usually not suspected and healthcare workers may not strictly be following the safety principles which are otherwise applied when HIV-infection is known or suspect, although universal precautions are routine practice. At this point, the risk of exposure is the highest and HIV-transmission to healthcare workers is the most likely to occur. The cases presented
here indicate that patients with progressive dyspnoea, which is typical of interstitial lung diseases, should undergo HIV-testing as a part of good clinical practice, even in a country with low-level HIV epidemic.
Keywords
bronchoscopy; chest X-ray; HIV-infection; HIV-testing
Hrčak ID:
65315
URI
Publication date:
16.3.2011.
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