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Case history: A 45-year-old man with a history of severe haemophilia A, multiple transfusions and associated hepatitis C and HIV infections (untreated by choice, last CD4 count 238/mm3 3 years prior) presented with worsening shortness of breath, cough and fever. Severe dyspnoea (respiratory rate 46/min), tachycardia (139/min) and hypoxaemia (oxygen saturation 80%) with bilateral alveolar infiltrates on mobile chest film necessitated immediate intubation. He was admitted to the intensive care unit, where shock, anuria, hypoglycaemia and jaundice soon developed. Blood cultures grew …
Contributors All authors treated the patient and prepared the manuscript, primarily written by AS, and YG prepared and interpreted the images.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Next of kin consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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