Crohn’s disease in human immunodeficiency virus-infected patient: A case report

Table 1 Relevant laboratory results (August)

Timeline	Analyte	Results
August 22, 2022	White blood count (× 109/L)	3.36
	Neutrophils (× 109/L)	2.20
	Lymphocytes (× 109/L)	0.40
	Red blood count (× 1012/L)	2.54
	Hemoglobin (g/L)	80
	Platelet count (× 109/L)	506
	Reactive protein C-reactive protein (mg/L)	5.07
	HIV 1/2 Ag/Ab combo (s/co)	472.53
	HIV 1/2 Ag/Ab combo	Positive
September 26, 2022	Lymphocyte count (%)	13.9
	Lymphocyte count (mm3)	391
	CD3+ CD4+ (T helper/inducers) (%)	48
	CD3+ CD4+ (T helper/inducers) (mm3)	188

Ag: Antigen; Ab: Antibody; CD3 or CD4: Cluster of differentiation 3 or 4; HIV: Human immunodeficiency virus.

Table 2 Crohn’s disease and human immunodeficiency virus treatment (in August)

Inpatient treatment
Crohn’s disease exacerbation treatment			HIV treatment
Prednisolone	30 mg × 1	5 mg/wk	Emtricitabine/tenofovir disoproxil	200 mg/245 mg × 1
Metronidazole	500 mg × 3		Dolutegravir	50 mg × 1
Mesalazine	2000 mg × 2
Azathioprine	50 mg × 2
Outpatient treatment
Crohn’s disease treatment			HIV treatment
Prednisolone	Eventually discontinued		Emtricitabine/tenofovir disoproxil		200 mg/245 mg × 1
Mesalazine	2000 mg × 2		Dolutegravir		50 mg × 1
Azathioprine	50 mg × 2

HIV: Human immunodeficiency virus.

Table 3 Case report timeline

Timeline	Remarks	Specific treatment (daily dosage)
September 25, 2022	2 background illnesses: CD and HIV	Background medication: Azathioprine 50 mg × 2 + mesalazine 2000 mg × 2. Dolutegravire 50 mg × 1. Emtricitabine + Tenofovir disoproxil 445 mg × 1
	PE	Oxygen (99.50%) 3 L/min (if SpO2 is < 95%). Ketorolac trometamol 30 mg (once). Calcium nadroparin 0.6 mL × 2. Amoxicilline + clavulanic acid 1200 mg × 4
September 27, 2022	CMV DNA detected: 420 copies/mL	Ibuprofen 400 mg (if > 38.5 °C). TMP + SMX 1920 mg × 3. Prednisolone 40 mg Ã-2 to 40 mg × 1 to 20 mg × 1
	EBV DNA detected: 13640 copies/mL P. jirovecii DNA detected Ct value: 25.79
September 30, 2022	Candida Ag (mannans): Positive	Fluconazol 150 mg × 1 to 300 mg × 1
October 14, 2022	New fever episode/sepsis	Azathioprine was suspended. Treatment of pneumocystosis (TMP + SMX and prednisolone) finished. Piperacillin + tazobactame 4500 mg × 4. Amikacine 250 mg × 2
October 17, 2022	E. coli detected in microbiological blood sample cultures	Piperacillin + tazobactame 4500 mg × 4. Amikacine 250 mg × 2. Paracetamol 1000 mg × 1 (if > 38.5 °C)
October 18, 2022	E. faecium detected in microbiological urine sample cultures
October 19, 2022	No clinical effect in terms of sepsis	Linezolid 600 mg × 2 added to antibiotic therapy
October 26, 2022	Acute conjunctivitis of both eyes	Hypromellose 1 mg × 4
October 31, 2022	Overall conditions stabilized

Ag: Antigen; CD: Crohn’s disease; CMV: Cytomegalovirus; Ct: Cycle threshold; DNA: Deoxyribonucleic acid; E. coli: Escherichia coli; E. faecium: Enterococcus faecium; EBV: Epstein Barr virus; HIV: Human immunodeficiency virus; P. jirovecii: Pneumocystis jirovecii; PE: Pulmonary embolism; SpO₂: Oxygen saturation; TMP + SMX: Trimethoprim + sulfamethoxazole.