This one is pretty sad.
You know how some patients tend to come back to haunt you over and over again?
Like this lady for instance. Right about 2 months ago, an MO called me for a consultation. He was referred this 20 something years old lady who was 22 weeks pregnant then and was diagnosed with HIV+. Apparently she was started on anti-HIV therapy by the O&G team but she defaulted because she could not tolerate the drugs.
I found out that the dosage of her drugs were too high and asked the MO to make the appropriate adjustments.
Three weeks later, she was sitting in my clinic, as a result of a referral from a district hospital where she was from. Apparently she defaulted her medications again because she did not like to take the medicine. This time it wasn’t the side effects, she simply didn’t want to take them. The referral was for my ‘expert opinion’ (I suspect they want me to convince her to take her meds).
I took a while to counsel her, stressing the need to be on medications, both for her health as well as for the sake of the unborn child within her. She wouldn’t hear of it. She was quite adamant that she wants no treatment.
I had no choice but to refer her back to the district hospital, replying with a letter in order for the doctors there to take the necessary steps to reduce HIV transmission to the child during birth.
And I thought that was the end of it.
Until 3 weeks ago, I was informed of an admission in the previous night. I was told she was a 20+ pregnant HIV+ woman who was admitted with status epilepticus. As I listened to the story, it was a bad dream come true. I knew it was the same lady.
She had to be intubated and ventilated. A CT brain was done which showed multiple lesions in the brain. A CSF examination revealed the presence of Cryptococcus.
Electron microscopy picture of Cryptococcus neoformans ~ how beautiful and yet, how deadly.
She passed away before the Raya, along with the child within her. We couldn’t save either of them.
It’s terribly sad.
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