Mary, a woman with a known HIV/AIDS, is brought to the emergency room by her husband after experiencing generalized body weakness for two days. Mary has not adhered to her antiretroviral therapy (HAART) for several months. Recently, she was given Septrin, IV Mannitol, and IV Cefuroxime at another facility.
In the emergency room, physicians observe that Mary is able to speak, indicating that her airway is unobstructed. Her lung sounds are clear, and her oxygen saturation level is at 97%. Her blood pressure is recorded at 105/67 mmHg, her heart rate is 107 beats per minute, and her capillary refill time is under 2 seconds. Her Glasgow Coma Scale score registers at 12 out of 15, and her blood glucose level stands at 5.7 mmol/L. Mary appears to be unwell, displaying a thin and pale complexion, with an intravenous line already established.
Mary’s husband provides additional information: she had been in her usual health until two days ago when she started feeling weak. Initial lab tests indicate increased white blood cells and protein in her urine, and a high parasite count, suggesting an infection. Further examination reveals Mary is confused but not feverish, pale, and not jaundiced. Her chest and heart examinations are normal, as is her abdomen. Neurologically, her GCS score is 13/15, and her motor function is intact. The urine dipstick shows trace protein and high white blood cells.
The healthcare team suspects altered mental status due to HIV/AIDS, with possible causes including malaria, a urinary tract infection (UTI), or cerebral toxoplasmosis.
Individuals living with HIV/AIDS, especially those who do not adhere to their prescribed medication regimen, frequently find themselves visiting the emergency room (ER) for a variety of reasons:
- Opportunistic Infections:
- HIV/AIDS patients have compromised immune systems, rendering them highly vulnerable to a variety of infections including malaria, urinary tract infections (UTIs), and cerebral toxoplasmosis. These infections pose a significant threat, as they can rapidly deteriorate and escalate, necessitating immediate and urgent medical intervention to manage and treat effectively.
- Medication Non-compliance:
- Defaulting on antiretroviral therapy (HAART) can lead to a decline in immune function, allowing opportunistic infections to take hold. This can cause symptoms like generalized weakness, fever, and confusion, necessitating an ER visit.
- Acute Symptoms:
- Sudden onset of severe symptoms like generalized body weakness, altered mental status, and fever can prompt immediate medical attention. In Mary’s case, her generalized weakness and confusion were signs that her condition had deteriorated significantly.
- Complications from Other Treatments:
- Treatments received at other facilities, such as IV medications, can sometimes cause adverse reactions or fail to address the underlying issue, leading to an ER visit for further management.
Individuals living with HIV/AIDS, particularly those who do not consistently follow their prescribed treatment plans, face an elevated risk of experiencing severe and unexpected health complications due to their compromised immune systems. Gaining insights into the typical causes of emergency room visits for these patients can facilitate earlier intervention and more effective management of their health conditions, ultimately leading to improved health outcomes and quality of life for them.
