INFECTIOUS DISEASES INSTITUTE

What happened to my chest

The price of a drug holiday

I can’t walk anymore

HIV positive woman with recurrent fevers and skin rash

Unconscious 9 months baby

Josephine 9 months is brought to the health center. she had been Sleeping all day long and won’t wake up.

2 year old girl with fever and difficulty in breathing

Alice 2, is brought by her mother for evaluation of fever and difficulty in breathing.

26 year old woman on ART

Karen 26, started ART 8 weeks ago and comes in today because she feels worse.

24 year old pregnant woman with cough

Celia 24, comes in with cough. She is 20 weeks pregnant.

31 year old man with fever

George is a 31-year-old man with fever. He comes to the clinic but has no danger signs or signs of severe disease.

31 year old woman with sore throat

Susan, a 31-year-old woman, comes to the clinic complaining of sore throat and white spots in her mouth.

27 year old man with diarrhea

Simon a 27 year old man, complains of profuse non watery diarrhea with 12 episodes that day.

Case scenario of 25 year old man with cough

Lucas a 25 year old male presented with cough that had lasted one month, with night sweats and fatigue. We present a case scenario in an imaginary clinical setting.

61 year old woman with cough, chest pain and back pain

N.P a 61 year old female who was readmitted to the hospital’s pulmonology unit. She presented with a one week history of cough, difficulty breathing, and back pain.

36 year old HIV positive woman with body swelling

P.B a 35year old HIV positive woman with body swelling. She also complained of productive cough of white sputum, associated chest pain and hemoptysis.

ARV treatment failure A case with phamacological and psychosocial determinants

Opio a 47 year old male was referred from hospital with a positive HIV test. He was registered at IDI clinic in January 2009, and found to be WHO clinical stage III. He was also HAART naïve.

End of Life Care

Achen a 41 year old female presented to the IDI clinic with a 5 month history of lower abdominal pain and vaginal bleeding. She also reported a one week history of vomiting.

The toxic side of Antiretroviral Therapy

Nandi presented with general body weakness and loss of appetite for 1 week.

I am not breast feeding

Solome presented to the infectious diseases clinic during a routine visit with right breast milk discharge for 10 months.

Managing HIV/HCV Co-Infection in a Resource Limited Setting

We report a case of an HIV positive man co- infected with hepatitis C showing a high viral load of HCV following 12 weeks of direct acting antiretrovirals. This case highlights the occurrence and challenges in HIV/HCV coinfection management in resource-limited seeting.

Vitamin B12 deficiency in HIV

This case highlights occurrence of vitamin B12 deficiency in an HIV infected patient thought to have resulted from prolonged use of PPI.

Sepsis and its management in a resource limited setting

This case highlights the occurrence of a community acquired resistant bacteria causing sepsis in an HIV positive patient and demonstrating sepsis management in a resource limited setting.

Blame it on drug interaction

We report of a 30-year-old female, HIV positive since August 2017, and had been on TDF/3TC/EFV for 6 months. She was virologically suppressed with a viral load of less than 20 copies/ml in February 2018. Clinically, intrauterine pregnancy of about 3months. This was an unwanted pregnancy.

I Want a Normal Baby

This is a real life case of a 32-year-old Ugandan female newly diagnosed HIV patient whose case was complicated by a diagnosis of cryptococcal meningitis and carriage of a twin pregnancy in a resource-limited setting.

Need for integrating non communicable diseases care into HIV clinics

NRL is a 51 year old female who presented to IDI HIV clinic in July 2010 with WHO stage II HIV disease as a referral from a lower health facility. She had been on ART since 2007, Tenofovir, Lamuvidine and Efavirenz combination.

Chronic Myeloid Lukemia in HIV

This is a case of a 46year old woman diagnosed HIV positive in 2009. She was WHO clinical stage I with a base line CD4 of 21cells. She was initiated on dapsone prophylaxis and AZT/3TC/NVP and her CD4 rose to 347cells. She was referred to the Infectious diseases institute (IDI) clinic in October 2012 for convenience.

Influence of co-morbidities in HIV on ART adherence

KI is a 51 year old male diagnosed with HIV infection and enrolled into care at the Infectious Diseases Institute (IDI) clinic in November 2015. He presented with persistent diarrhoea, itchy skin rash and oral candidiasis.

A case report of an Epileptic HIV positive woman with treatment failure due to suspected drug interaction

NKS, a 28year old HIV positive woman was registered at the Infectious Diseases Institute (IDI) clinic in 2007. By that time she was a known epileptic attending the Mulago psychiatric clinic controlled on anticonvulsants (carbamazepine).

Leprosy developing as part of the immune reconstitution Syndrome in an HIV1 positive patient on HAART – a Ugandan experience

Leprosy, presenting as part of the immune reconstitution syndrome (IRIS) in patients on highly active anti-retroviral therapy (HAART) has been documented. The increasing availability of HAART in countries endemic for leprosy may lead to unmasking of latent leprosy in co-infected patients.

HIV positive pregnant woman with Chronic Inflamatory Demyelinating Polyneuropathy

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a relatively rare disease. It has been associated with HIV and less commonly pregnancy. We report a case of a 32 year old HIV positive pregnant woman in her second trimester, diagnosed with CIDP after a 3months history of progressive failure to walk.

Guideline practical GAPS in managing an HIV positive woman with low level viremia

This case highlights management challenges in practical situations not addressed by existing guidelines and recommends patients with a detectable low viremia <1000 copies/ml to have their viral load repeated within a period of 3 months from the first assessment after receiving intensive counselling.

A 56 year old HIV infected woman with Chronic Headache

A 56 year old HIV-infected woman not on antiretroviral therapy (ART) presented to Kiboga District hospital (DH) with a 2month history of headache and vertigo, with associated mild confusion, memory loss, drooping of the right eye, dizziness and a staggering gait for 2 weeks.

From stable HIV to PCP in a matter of months

A 22-year-old girl with CD4 of 795 and This young woman tested positive for HIV at the age of 18. She had a CD4 count of two (0%) and a viral load of 256,830 copies/ml. Her parents died when she was two years old and her auntie brought her up. She denied any prior sexual intercourse.

Esophageal Candidiasis in a Virologically suppressed HIV-Infected woman

A 46year old female diagnosed with HIV-infection and enrolled into care at the IDI clinic in July 2009. She presented with esophageal candidiasis, a stage IV disease at a baseline CD4 cell count of 56cells/ul. She was started on ART; tenofovir, lamivudine and zidovudine in October 2009 and her CD4 peaked to 202cells five months later.

A 32 year old female with Takayasu Arteritis in HIV from a resource limited setting

Takayasu arteritis (TA) is a rare, systemic, inflammatory large-vessel vasculitis that most commonly affects women of childbearing age. The precipitant factor of the pathological immune response is generally unknown and different factors have been implicated, including human immunodeficiency virus (HIV) infection.

An HIV Positive woman; slow progress with persistent small viral load

This case highlights the occurrence of persistent low level viremia sensitive to treatment in an HIV patient with good adherence that later developed resistance.

A 42 year old female with HIV-associated lymphoma

These case details a 42 year old Ugandan female HIV positive well controlled immunologically and virologically on Highly Active Anti-Retroviral Therapy (HAART), confirmed to have HIV-associated lymphoma after 7 months of presentation with a painful right eye that later progressed into a mass.

48 year old female with squamous cell carcinoma of the tongue in HIV

We report case of a 48year old female HIV positive patient on HAART who was immunologically and virologically well controlled with squamous cell carcinoma of the tongue. This case high lights a patient with squamous cell carcinoma of the tongue in HIV with its associated diagnostic and management challenges in a resource limited setting.

50 year old female with overthypothyroidism in HIV

We report a case of a 50 year old Ugandan female HIV positive on HAART, immunologically and virologically well controlled, with overt hypothyroidism who presented with polyphagia and weight loss.

HIV positive man with chronic hepatitis B virus (HBV) infection complicated with liver cirrhosis

We report a case of a 46year old HIV positive man with chronic Hepatitis B virus (HBV) infection complicated with liver cirrhosis and stage III chronic kidney disease on ART. This case high lights the occurrence of liver cirrhosis complicated with stage III chronic kidney disease in HIV patients in a resource limited setting, showing ART.

A 36 year old Female with Rheumatoid Arthritis

This case highlights the occurrence of inflammatory illnesses among HIV patients in a resource limited setting, showing management challenges, and increasing awareness among clinicians.