HIV-Associated Mycobacterium Avium Complex, Oral Candida, and SARS-CoV-2 Co-Infection: A Rare Case Report

Abstract

Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly to become a global pandemic. Opportunistic infections (OIs) are common in patients with acquired immunodeficiency syndrome (AIDS). Mycobacterium avium complex (MAC) and oral candidiasis (OC) are frequently responsible for such infections. Here, we describe a patient with a recent history of COVID-19 who was also diagnosed with human immunodeficiency virus (HIV), MAC, and OC. Case Presentation The patient was a 23-year-old woman with a past medical history of HIV infection who was diagnosed with SARS-CoV-2 infection 6 days prior to her referral to hospital. Her chief complaints were chest distress and continuous fever with a background of a 5-month history of anemia and tuberculosis (TB). Chest X-ray showed bilateral parenchymal infiltrates suspicious for COVID-19. She was treated with oxygen, empiric antibacterial and antiretroviral therapy. Further workup showed MAC and OC infection. She was started on ethambutol, rifampin and antifungal treatment for influenzas and her symptoms resolved in 8 weeks. Follow-up chest computed tomography scanning showed that the lung lesions disappeared within a short period of time. Conclusion A thorough history and clinical examination are vital to arriving at the correct diagnosis or diagnoses. With the COVID-19 pandemic, clinicians caring for immunosuppressed patients need to remain vigilant of the simultaneous presence of OIs. This report highlights the importance of the treatment and prevention of OIs in HIV-infected persons, which may reduce adverse consequences after infection with SARS-CoV-2.

The Oral Lesion in the COVID-19 Patient: Is It True Oral Manifestation or Not?

“…Most of the lesion was ulcer, 42 , 74 , 85 , 89 , 99 , 110 , 123 vesicle, 42 , 80 erythema, 42 , 80 pseudomembrane, 42 erosion, 42 , 80 crust 42 , 111 and atrophy. 42 , 94 Other lesions were depapilation, 74 oedema, 42 macule, 42 petechiae 94 and plaque 103 ( Table 13 ).…”

“… 42 , 94 Other lesions were depapilation, 74 oedema, 42 macule, 42 petechiae 94 and plaque 103 ( Table 13 ).…”

“…The underlying disease found in men and women was different. Most hypertension, 42 , 80 , 89 diabetes mellitus, 42 , 85 , 89 , 111 hyperthyroidism, 42 , 74 osteoarthritis, 80 hypothyroidism, 111 rheumatoid arthritis, 94 severe dystonia, 123 epilepsy, 123 arterial hypertension, 110 chronic hepatopathy, 110 hypercholesterolemia, 110 gastroesophageal reflux disease, 110 HIV 103 and asthma 99 ( Table 13 ).…”