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Washington University Experience | NEOPLASMS (HEMATOLYMPHOID) | Lymphoma, immune-compromised | 11A0 Case 11 History
Case 11 History ---- The patient was a 32 year old man with a history of oral and intravenous drug abuse. He was diagnosed with AIDS in 1987 when he presented with disseminated histoplasmosis. Since that time he has suffered further complications of AIDS, namely CMV colitis, oral candidiasis. ascending myelopathy and encephalopathy. Trials of AZT, plasmapheresis, and prednisone did not reverse the myelopathy. The patient was therefore bedridden since 1988. His preterminal course was significant for cachexia, decubitus ulcers and urinary tract infection secondary to chronic Foley catheter insertion. The patient was cared for at home. On the day of admission he was found by Home Health nurses to be virtually unresponsive. He was admitted to BJH in February 1989 where physical exam found a cachectic man, intermittently responsive with a dysconjugate gaze. On admission, in accordance with the patient's previously stated wishes, the care plan was for rehydration and comfort only. On the fourteenth hospital day the patient was found without spontaneous pulse or respirations and was pronounced dead.
