The Importance of a Watchful Eye: Multiple Infections in Immunocompromised Patient

Abstract

INTRODUCTION/OBJECTIVES: Immunocompromised patients are a unique subset of the population that require special attention and care. These individuals are susceptible to a wide range of infections and illnesses, and even minor symptoms can be indicative of a more serious underlying condition. Unfortunately, due to the immunocompromised state, symptoms can often be less severe or easily overlooked, leading to delayed diagnosis and treatment. CASE PRESENTATION: A 77-year-old female patient presents to the ER complaining of breathing difficulties, productive cough, and fever. 11 days earlier, she reported catarrhal symptoms. The patient is being treated for marginal zone non-Hodgkin B-cell lymphoma and is currently receiving R-CVP chemotherapy protocol and corticosteroids. Both her condition and treatment make her immunocompromised, so she was prescribed levofloxacin which she did not take. From the ER, the patient was admitted to the hematology department and further work-up was done. CRP was unremarkably elevated, but chest X-ray showed perihilar destruction of the right lung. Bronchoalveolar lavage came back positive for CMV, EBV, Klebsiella pneumoniae, Enterococcus raffinosus, and Pneumocystis jirovecii. CONCLUSION: This case report highlights the importance of recognizing and addressing even minor symptoms in immunocompromised patients and the importance of vigilant monitoring and prompt intervention in this vulnerable population to prevent the development of more serious conditions. It also highlights the need for clinicians to maintain a high index of suspicion and promptly investigate any changes in the patient’s condition, no matter how minor they may seem. CR72 The importance of CT-guided adrenal biopsy in an oncological patient: a case report Ante Listeša, Tajana Turkb