A 78-year-old grandmother, CC, presented to the emergency room with symptoms including night sweats, hot flashes, insomnia, and unintentional weight loss. She had a history of eating raw cookie dough every week, which contained uncooked eggs that potentially harbored salmonella bacteria. Despite initial concerns about salmonella food poisoning, CC's symptoms and test results suggested a more complex underlying issue.
Further testing revealed that CC had kidney failure, anemia, and a compromised immune system. She was initially treated with corticosteroids, but her condition worsened, and she developed a severe infection. A bone biopsy eventually confirmed that she had salmonella enteritidis, a bacteria commonly found in uncooked eggs.
The medical team discovered that CC had a severely compromised immune system, which led them to suspect that she might have Acquired Immunodeficiency Syndrome (AIDS). HIV testing confirmed that she was HIV-positive, with a viral load of 550,000 copies per milliliter of blood and a CD4 count of 60 cells per milliliter.
CC's case highlights the importance of considering HIV/AIDS in older adults, even if it's not the first suspected diagnosis. Her infection was likely acquired through a blood transfusion in Latin America in the 1990s, although this cannot be confirmed.
With the initiation of antiretroviral therapy, CC's viral load became undetectable, and she made a full recovery. Her case serves as a reminder to healthcare providers to consider HIV/AIDS in older adults and to take a thorough medical history, including information about sexual activity and potential exposure to contaminated blood products.
Here are the key facts from the text:
1. CC is a 78-year-old woman who was admitted to the emergency room with night sweats, hot flashes, and insomnia.
2. She had unintentionally lost at least 25 pounds over the last 2 months.
3. CC was a grandma who baked cookies for her grandkids every week and ate some of the cookie dough.
4. She had type 2 diabetes, high blood pressure, and a heart condition known as atrial fibrillation.
5. Analysis of CC's blood found anemia.
6. She had anemia 2 months earlier, but it had worsened.
7. Her kidneys were failing, with a massive amount of protein in her urine.
8. CC was diagnosed with deposits of antibodies and complexes in the capsules of her kidneys.
9. She had an acute infection caused by Salmonella enteritidis, the bacteria commonly found in uncooked eggs from cookie dough.
10. High-dose corticosteroids increased the risk of infection, which led to a second round of infection.
11. CC was diagnosed with osteomyelitis, a bone infection caused by Salmonella enteritidis.
12. She had a rash that was not characteristic of an antibiotic hypersensitivity.
13. CC was diagnosed with Acquired Immunodeficiency Syndrome (AIDS) at the age of 78.
14. She had a viral load of 550,000 copies per milliliter of blood and a CD4 T cell count of 60 cells per milliliter.
15. CC had a blood transfusion in Latin America 25 years ago, which may have led to her HIV infection.
16. She started triplet antiretroviral therapy and had an undetectable viral load after 6 months.
17. Her rash resolved, kidney function improved, and her bones healed.
18. CC was able to sustain a full recovery with support from her family and medical team.