title: Undiagnosed AIDS in patients with progressive dyspnoea: an occupational risk for healthcare workers in Croatia.
abstract: Pulmonary diseases are well documented and diverse in many patients with HIV in clinical stages 3 and 4. It is not unusual that these patients, most of whom do not know that they are already HIV-infected, are first examined and hospitalised by respiratory medicine specialists. While HIV-infection is relatively simple to diagnose if accompanied by advanced clinical manifestations and is regularly checked in patients with increased risk, this is not the case in low-risk patients, particularly in countries with low-level HIV epidemic and therefore low index of suspicion. Regular examination involves a series of tests, often including bronchoscopy with transbronchal lung biopsy in order to identify an interstitial lung disease and/or progressive dyspnoea. It is not uncommon that patients provide false or incomplete information about their lifestyle, which can mislead the clinician. At this point, HIV-infection is usually not suspected and healthcare workers may not strictly be following the safety principles which are otherwise applied when HIV-infection is known or suspect, although universal precautions are routine practice. At this point, the risk of exposure is the highest and HIV-transmission to healthcare workers is the most likely to occur. The cases presented here indicate that patients with progressive dyspnoea, which is typical of interstitial lung diseases, should undergo HIV-testing as a part of good clinical practice, even in a country with low-level HIV epidemic.
authors.affiliation: Clinical Department for Pulmonary Diseases, Split University Hospital, Zagreb, Croatia. kornelijamise@yahoo.com
authors.forename: Kornelija
authors.initials: K
authors.lastname: Miše
authors.forename: Maja
authors.initials: M
authors.lastname: Vučković
authors.forename: Anamarija
authors.initials: A
authors.lastname: Jurčev-Savičević
authors.forename: Ivan
authors.initials: I
authors.lastname: Gudelj
authors.forename: Irena
authors.initials: I
authors.lastname: Perić
authors.forename: Joško
authors.initials: J
authors.lastname: Miše
mesh_terms: D015492:AIDS Serodiagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000635:transmission; D000328:Adult; D017523:Croatia; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged