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Lopez A, Bacha J, Kovarik C, et al. Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child. Children (Basel). 2021;8(4)doi: 10.3390/children8040273.
Lopez, A., Bacha, J., Kovarik, C., & Campbell, L. (2021). Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child. Children (Basel, Switzerland), 8(4), . https://doi.org/10.3390/children8040273
Lopez, Alison, et al. "Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child." Children (Basel, Switzerland) vol. 8,4 (2021). doi: https://doi.org/10.3390/children8040273
Lopez A, Bacha J, Kovarik C, Campbell L. Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child. Children (Basel). 2021 Apr 02;8(4). doi: 10.3390/children8040273. PMID: 33918245; PMCID: PMC8065956.
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Children (Basel). 2021 Apr 02;8(4). doi: 10.3390/children8040273.

Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child.

Children (Basel, Switzerland)

Alison Lopez, Jason Bacha, Carrie Kovarik, Liane Campbell

Affiliations

  1. Pediatric Infectious Diseases, University of Manitoba, Winnipeg, MB R3E3P5, Canada.
  2. Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX 77030, USA.
  3. Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
  4. Baylor College of Medicine Children's Foundation-Tanzania, Mbeya 53107, Tanzania.
  5. Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.

PMID: 33918245 PMCID: PMC8065956 DOI: 10.3390/children8040273

Abstract

Histoplasmosis is an uncommon opportunistic infection in human immunodeficiency virus (HIV) positive children. The most common form is primary disseminated histoplasmosis, characterized by persistent fever and failure to thrive. A 10-year-old HIV positive girl presented to the Baylor College of Medicine Children's Foundation-Tanzania Mbeya Center of Excellence (COE) with ulcerated skin lesions and a violaceous facial rash. She also had persistent fevers, severe acute malnutrition, and severe anemia. At diagnosis, the patient was failing first line antiretroviral therapy (ART) with a cluster of differentiation 4 immune cells (CD4) of 24 cells/µL and an HIV viral load (VL) of 196,658 cp/mL. The patient was changed to a second line ART regimen (abacavir, lamivudine, and ritonavir-boosted lopinavir) and received nutritional support, blood transfusions, multiple antibiotics, and meticulous wound care. She also received comprehensive symptom management, psychosocial support, and emergency housing through the COE's palliative care program. Biopsy of a lesion showed intracytoplasmic organisms consistent with

Keywords: HIV/acquired immunodeficiency syndrome (AIDS); global health; histoplasmosis; pediatrics; resiliency; symptom management

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