atovaquone / Generic mfg. - LARVOL DELTA

A Case of Pneumocystis Pneumonia Caused by Long-Term Low-Dose Steroid Therapy. (PubMed, Cureus) - "We report our experience of managing PCP in an 80-year-old man with a history of rheumatoid arthritis who had been receiving oral prednisolone 4 mg/day for 21 years...These findings led to the suspicion of bacterial pneumonia and initiation of ceftriaxone therapy...On day five, the antibiotic regimen was switched to meropenem, vancomycin, and TMP-SMX...ST and atovaquone were administered for a total of three weeks, resulting in defervescence and significant improvement in oxygenation...Although our patient had been receiving only a low daily dose, the cumulative exposure indicated a high risk for infections such as PCP. In conclusion, our case experience suggests that in patients receiving long-term corticosteroid therapy, PCP and other opportunistic infections must be considered in the differential diagnosis of pneumonia, regardless of the daily corticosteroid dose received."

Journal • Cough • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Arthritis • Pneumonia • Pulmonary Disease • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • CD4

Pneumocystis jirovecii pneumonia in patients with hematologic malignancy: Risky business, but for whom? (ASH 2025) - "Many of these patients had undergone advanced,immunomodulatory treatments, including 11 (20%) with hematopoietic cell transplantation, 3 (5.5%) withchimeric antigen receptor T-cell therapy, 2 (3.6%) with bispecific T-cell engager therapy, and 16 (29%) withrituximab. Six of the 55 patients (10.9%) were on PJP prophylaxis at the time of infection, including 4(7.3%) on atovaquone and 2 (3.6%) on trimethoprim-sulfamethoxazole... Recent advances in chemo-immunotherapy have drastically altered the treatment landscape for HM,often inducing profound immunosuppression. Our study highlights the importance of optimizing PJPprophylaxis among these patients, particularly those undergoing treatment with novel therapies. Most ofthe patients were not on PJP prophylaxis at the time of diagnosis, underscoring the need to further refinethe institutional guidelines on criteria for prophylaxis."

Clinical • Acute Myelogenous Leukemia • Adult T-Cell Leukemia-Lymphoma • B Cell Lymphoma • Diffuse Large B Cell Lymphoma • Hematological Malignancies • Infectious Disease • Leukemia • Lymphoma • Multiple Myeloma • Non-Hodgkin’s Lymphoma • Oncology • Pneumonia • Respiratory Diseases

Autoimmune hemolytic anemia: An underrecognized contributor to anemia and hemolysis in babesiosis infection (ASH 2025) - "Most received the standardantibiotic regimen of atovaquone, azithromycin and doxycycline. Data was analyzed for 406 patients. Median age was 73 (range 2 to 103) with a malepredominance (67.5%; 264/406). Asplenia was seen in 10.7% (42/406), and 32.5% (127/406) had Lyme-coinfection."

Anemia • Autoimmune Hemolytic Anemia • Hematological Disorders • Immunology • Infectious Disease

Atovaquone Attenuates Hypertrophic Cardiomyopathy via MARCH3-Mediated GP130 Degradation (AHA 2025) - "The use of leupeptin, but not MG132, reversed GP130 downregulation, confirming lysosomal pathway specificity.CONCLUSIONThis study identifies Atovaquone as a repurposed, disease-modifying candidate for HCM therapy. By targeting MARCH3 and inducing lysosomal degradation of GP130, it disrupts pathological STAT3 signaling. These findings provide both mechanistic insight and translational potential for a novel therapeutic approach in HCM."

Cardiomyopathy • Cardiovascular • Fibrosis • Hypertrophic Cardiomyopathy • Immunology • Targeted Protein Degradation

Treatment of Dapsone-Induced Methemoglobinemia in a Transplant Recipient With Isosulfan Blue Allergy (ACG 2025) - "1 month post-LT, pneumocystis jirovecii pneumonia (PJP) prophylaxis was switched from sulfamethoxazole/trimethoprim (SMZ/TMP) to dapsone due to renal impairment...Dapsone was switched to atovaquone, which was not tolerated due to nausea; and was restarted 21 days later. Other medications included tacrolimus, cellcept and valcyte...Cimetidine use was weighed with balancing the risks for kidney injury due to acute interstitial nephritis with recent KT with improvement in MethHb.Figure: Figure 1. Methemoglobin Level after Cimetidine Initiation*Day of Cimetidine 400mg TID for 5 days initiation"

Clinical • Allergy • Anemia • Fatigue • Fibrosis • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Leukopenia • Metabolic Dysfunction-Associated Steatohepatitis • Nephrology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Transplantation • G6PD • HP

A Case of Catastrophic Antiphospholipid Syndrome Manifesting as Abdominal Pain (ACG 2025) - "He was treated with another steroid course, plasmapheresis, and Rituximab, with significant improvement. He was discharged home on prednisone, atovaquone, pantoprazole, warfarin, and vitamin D. This is a rare case of CAPS presenting as non-specific abdominal pain following warfarin discontinuation...Figure: Figures 1A-C: Initial CT A/P of the liver reveals an enlarged spleen and gastric distention without evidence of infarction​.Figures 1D-F: Repeat CT A/P imaging done after APS flare-up, four days after initial presentation. Multiple new hypoattenuating lesions in the liver are visible, consistent with multiple infarcts.Figure: Figures 2A-2C: Esophagogastroduodenoscopy to work up gastric distension showed diffuse inflammation indicating gastritis in the body and upper body of the stomach (2A, 2B), with scattered gastric purpura in the antrum (2C)."

Clinical • Acute Kidney Injury • Cardiovascular • Complement-mediated Rare Disorders • Gastrointestinal Disorder • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Inflammation • Inflammatory Arthritis • Ischemic stroke • Nephrology • Pain • Peptic Ulcer • Renal Disease • Rheumatoid Arthritis • Rheumatology • Thrombocytopenia • Thrombosis

SEVERE PNEUMOCYSTIS PNEUMONIA IN A NON-HIV PATIENT: A CAN'T-MISS DIAGNOSIS (CHEST 2025) - "She had received several cycles of chemotherapy and atezolizumab before developing ICI colitis, which was treated with infliximab and steroids...Initial testing revealed a positive beta-D-glucan (BDG), prompting empiric treatment for PJP with atovaquone, given her sulfa allergy...Her prednisone dosage was increased, and she was transitioned to clindamycin and primaquine for severe PJP pneumonia... Identifying PJP in non-HIV patients can be challenging, but it has significant implications for treatment and prognosis. Diagnosis can be straightforward if BDG is positive and if sputum samples are obtainable, but results may take several days to return. Treatment should not be delayed if there is high clinical suspicion, with trimethoprim-sulfamethoxazole being the first line choice."

Clinical • Cough • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Lung Cancer • Pneumonia • Respiratory Diseases • Small Cell Lung Cancer • Solid Tumor

A PATIENT WITH WALDENSTROM MACROGLOBULINEMIA AND BILATERAL INFILTRATES: WHAT CAN IT BE? (CHEST 2025) - "Trimethoprim-sulfamethoxazole remains the corner stone for therapy with atovaquone and combination of clindamycin - primaquine serving as alternative agents. Ibrutinib should be held during active infection. Currently, the incidence rates of PJP infection in patients with Waldenstrom macroglobulinemia on ibrutinib therapy being less than 5%, there are no guidelines to start PJP prophylaxis in such patients."

Clinical • Cough • Dermatology • Fatigue • Hematological Malignancies • Immunology • Infectious Disease • Lymphoma • Lymphoplasmacytic Lymphoma • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Solid Tumor • Vasculitis • Waldenstrom Macroglobulinemia

A CASE OF PREDNISOLONE TREATMENT FOR PAZOPANIB-INDUCED HEPATOTOXICITY (CHEST 2025) - "Given these findings, decision was made to discontinue his treatment on trial, and to pursue next line systemic therapy with single agent trabectedin VS pazopanib...The patient was also started on Trimethoprim/Sulfamethoxazole and Protonix for pneumocystis carinii pneumonia and gastrointestinal prophylaxis respectively...Due to improvement in liver function testing, he was discharged home on prednisolone 80 mg daily for 9 days, Protonix 40 mg daily before breakfast, and atovaquone... This case highlights the utility of corticosteroid treatment such as prednisolone as a means of treating pazopanib-induced hepatotoxicity. Early recognition and prompt immunosuppressive treatment may mitigate severe PIH and improve patient outcomes."

Clinical • Genito-urinary Cancer • Hepatology • Immunology • Infectious Disease • Liver Failure • Pneumonia • Renal Cell Carcinoma • Respiratory Diseases • Sarcoma • Soft Tissue Sarcoma • Solid Tumor • HLA-B

NEGATIVE PJP SMEAR IN AN HIV-NEGATIVE IMMUNOCOMPROMISED PATIENT (CHEST 2025) - "CASE PRESENTATION: An 89-year-old male with medical history most notable for unresectable mesothelioma previously treated with ipilimumab and nivolumab complicated by complete heart block requiring permanent pacemaker placement and one month of high dose steroids, later treated with palliative carboplatin/pemetrexed; recurrent right sided pleural effusions; atrial fibrillation; and prostate cancer s/p partial prostatectomy presented after uncomplicated outpatient thoracentesis for evaluation of dyspnea with rest and hypoxia requiring four liters per minute (LPM) of oxygen via nasal cannula (NC)...Patient was subsequently started on sulfamethoxazole-trimethoprim and prednisone, with resolution of hypoxemia and improvement in clinical status. Patient was later transitioned to atovaquone due to hyperkalemia... This case highlights the importance of considering a patient's clinical picture in conjunction with laboratory testing in the management of PJP infection."

Clinical • Atrial Fibrillation • Congestive Heart Failure • Genito-urinary Cancer • Heart Failure • Hematological Malignancies • Infectious Disease • Mesothelioma • Pneumonia • Prostate Cancer • Pulmonary Disease • Respiratory Diseases • Solid Tumor

HYPERCALCEMIA, A RARE MANIFESTATION OF A PNEUMOCYSTIS JIROVECII PNEUMONIA (PJP) INFECTION IN RENAL TRANSPLANT PATIENT: A CASE REPORT (CHEST 2025) - "CASE PRESENTATION: A 73-year-old male with a history of ESRD status post two DDKTs, prostate cancer treated with prostatectomy, and an 80-pack-year smoking history was immunosuppressed with cyclosporine, prednisone, belatacept, and Myfortic...He was treated with loop diuretics, calcitonin, and zoledronic acid...He was initially treated with Bactrim, later transitioned to Atovaquone for 21 days, with plans for long-term PJP prophylaxis... PJP-associated hypercalcemia can present subtly. In this case, it was repeatedly treated and investigated, ultimately becoming a diagnosis of exclusion after BAL samples tested positive for PJP. While PJP typically presents with respiratory symptoms such as cough and shortness of breath, this case was unique, with initial symptoms of fatigue, generalized weakness, and hypercalcemia.Therefore, in patients with respiratory symptoms, concerning imaging findings, and/or hypercalcemia, it is essential to not only evaluate the hypercalcemia..."

Case report • Clinical • Anorexia • Chronic Kidney Disease • Cough • Endocrine Disorders • Fatigue • Genito-urinary Cancer • Human Immunodeficiency Virus • Immunology • Infectious Disease • Metabolic Disorders • Pneumonia • Prostate Cancer • Rare Diseases • Renal Disease • Respiratory Diseases • Sarcoidosis • Solid Organ Transplantation • Solid Tumor • Transplantation

BABESIOSIS CAUSING HYPERCAPNIC RESPIRATORY FAILURE: A RARE COMPLICATION (CHEST 2025) - "CASE PRESENTATION: 62-year-old male with a history of autoimmune epilepsy on rituximab presented initially with progressive dyspnea and fatigue...The patient demonstrated marked clinical improvement after initiation of azithromycin and atovaquone for babesiosis, leading to successful extubation... Clinicians should consider babesiosis in patients from endemic regions presenting with unexplained respiratory failure. Early recognition and targeted antiparasitic treatment can prevent unnecessary interventions and significantly improve patient outcomes."

Acute Respiratory Distress Syndrome • Anemia • CNS Disorders • Epilepsy • Fatigue • Hematological Disorders • Immunology • Infectious Disease • Musculoskeletal Pain • Myasthenia Gravis • Obstructive Sleep Apnea • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sleep Disorder • HP

DIFFUSE ALVEOLAR HEMORRHAGE IN IGA VASCULITIS: A RARE COMPLICATION AND DIAGNOSTIC CHALLENGE (CHEST 2025) - "She was diagnosed with a urinary tract infection and treated with cefdinir and fluconazole...She was given a one-time dose of furosemide along with a steroid taper and referred to both outpatient dermatology and rheumatology...She developed acute kidney injury (AKI); therefore, trimethoprim/sulfamethoxazole was discontinued and replaced with atovaquone...A skin punch biopsy of her rash revealed vasculopathic changes, lumen occlusion, epidermal necrosis, and re-epithelialization.Given her pulmonary-renal syndrome, skin biopsy findings and high clinical suspicion for IgAV, plasmapheresis, and rituximab were promptly initiated while awaiting confirmation with renal biopsy... DAH in adults with IgAV is a severe complication with significant morbidity and mortality; although rare, this can be effectively managed if recognized and treated early. Therefore, it is crucial to maintain a high index of clinical suspicion for IgAV with DAH in patients presenting with pulmonary-renal..."

Acute Kidney Injury • Breast Cancer • Chronic Obstructive Pulmonary Disease • CNS Disorders • Dermatology • Glomerulonephritis • Infectious Disease • Lupus Nephritis • Multiple Sclerosis • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases • Rheumatology • Solid Tumor • Vasculitis

Antibiotic Prophylaxis During Treatment of Anca-associated Vasculitis with Rituximab: Data from a Multicenter Cohort (ACR Convergence 2025) - "We stratified characteristics (at time of starting RTX induction or maintenance, as applicable) according to concurrent antibiotic prophylaxis (e.g. trimethoprim sulfamethoxazole [TMP-SMX], dapsone, atovaquone), and compared groups using 95% confidence interval (CI) for the differences in mean or proportion, or the Mann Whitney U test as applicable. In this multicenter cohort initiating RTX for induction or maintenance, 80% of the participants were taking antibiotic prophylaxis, which is higher than reported in other cohorts. During the induction and maintenance period, concurrent prednisone was associated with prophylaxis, as was higher disease activity during induction. Our findings provide additional insight into the patterns of antibiotic prophylaxis use in AAV."

Clinical • ANCA Vasculitis • Rare Diseases • Vasculitis

NOCARDIA INFECTION IN LUNG TRANSPLANT RECIPIENTS: CASE SERIES (CHEST 2025) - "The most common reasons for discontinuing or reducing TMP-SMZ were hyperkalemia, transaminitis, leukopenia, and sulfa-related hypersensitivity reactions.Risk factors for Nocardia infection included augmented immunosuppression (IS), with one case treated with methylprednisolone for incidental COVID-19 (Case 4), and routine immunosuppression with cell cycle inhibitors (mycophenolate mofetil or azathioprine) and calcineurin inhibitors (tacrolimus)...Extrapulmonary manifestations included one report of central nervous system (CNS) lesions and abscess (Case 3), and pericardial and pleural effusions.The treatment regimens for Nocardia included levofloxacin or moxifloxacin, linezolid, and Augmentin... Atovaquone or suboptimal dosing of TMP-SMX does not provide protection against Nocardia infections lung transplant recipients (LTR). Every effort should be made to ensure consistent use of appropriate prophylaxis, especially when augmented immunosuppressive regimens are employed..."

Clinical • Bone Marrow Transplantation • Hematological Disorders • Idiopathic Pulmonary Fibrosis • Immunology • Infectious Disease • Leukopenia • Novel Coronavirus Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Organ Transplantation • Transplantation

BREATHLESS FROM THE BITE: ARDS DUE TO BABESIOSIS (CHEST 2025) - "A week prior, he had visited his PCP for a new onset rash associated with a 2-week history of intermittent fevers, and muscle aches; subsequently tested positive for Lyme IgG and IgM antibodies and was started on doxycycline...Antibiotics were switched to IV Ceftriaxone 2gm daily for Lyme disease coverage; Azithromycin 1gm daily and PO Atovaquone 750mg Q12 were started for presumptive babesia coinfection... Clinicians should have a high degree of suspicion of coinfections with Lyme disease as well as suspect these infections in persons traveling to non-endemic US regions. ARDS is a rare complication of babesiosis. Timely recognition and appropriate management are crucial for improving outcomes."

Acute Respiratory Distress Syndrome • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Respiratory Diseases • Thrombocytopenia

DELAYED DIAGNOSIS OF SEVERE BABESIOSIS LEADING TO MULTIORGAN FAILURE AND TREATMENT WITH RED CELL EXCHANGE TRANSFUSION (CHEST 2025) - "Atovaquone, azithromycin, and doxycycline were initiated...The Infectious Disease Society of America (IDSA) recommends combination regimen of atovaquone and azithromycin, or clindamycin and quinine as an alternative... Currently, there is no established protocol or validated method to assess the impact of red cell exchange transfusion on mortality in human babesiosis. This case highlights the need for prospective studies and randomized controlled trials to evaluate the timing of symptom onset, medical therapy initiation, and the risks and benefits of concurrent red cell exchange. Additionally, further research is needed to understand severe disease without significant parasitemia and identify key prognostic factors for managing babesiosis."

Acute Kidney Injury • Anemia • Autoimmune Hemolytic Anemia • Cardiovascular • CNS Disorders • Coronary Artery Disease • Hematological Disorders • Hepatology • Hypotension • Immunology • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Otorhinolaryngology • Renal Disease • Thrombocytopenia

DAPSONE-RELATED METHEMOGLOBINEMIA TREATED WITH HIGH-DOSE ASCORBIC ACID IN A LUNG TRANSPLANT RECIPIENT (CHEST 2025) - "Patient was initially found to have influenza A treated with oseltamivir and later found to have sputum culture positive for Pseudomonas aeruginosa treated with levofloxacin...She was found to have a lower extremity deep vein thrombosis and was treated with intravenous heparin...Prior to admission, patient was prescribed dapsone for PJP prophylaxis after prior intolerance sulfamethoxazole-trimethoprim and atovaquone... High dose ascorbic acid is an effective treatment for methemoglobinemia caused by dapsone. Treatment resulted in near normalization of methemoglobin levels and improvement in oxygen requirements, hypoxia and dyspnea. Due the long half-life of dapsone, additional doses may be required."

Clinical • Cardiovascular • Chronic Kidney Disease • Fatigue • Hematological Disorders • Immunology • Infectious Disease • Influenza • Metabolic Disorders • Nephrology • Pneumonia • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Transplantation

Evaluation of Atovaquone's Blocking Activity on Clinical Isolates of Plasmodium falciparum Gametocytes and Sporogony (ASTMH 2025) - "The ex vivo tests revealed 100% blocking activity on transmission at a concentration of 10nM atovaquone. Gametocyte morphology was disturbed, characterized by an increased volume of the gametocyte at 10nm, changes in nuclear organization at 100nm, fragmentation, and vesiculation at 1µM.In the sporogony tests, we observed complete inhibition of oocyst development in the mosquito gut at 100nM atovaquone.Atovaquone exhibits potent activity against gametocytes and inhibits sporogony in the mosquito vector."

Clinical • Infectious Disease • Malaria

A CASE OF COINFECTION OF BABESIOSIS AND LYME DISEASE IN A PATIENT WITH NO RISK EXPOSURE (CHEST 2025) - "The initial parasitemia was 12%, and the patient was started on Azithromycin and Atovaquone with a decrease in parasitemia 6.6%...Treatment for Lyme disease was initiated with doxycycline... This case underscores the diagnostic and therapeutic challenges posed by the co-infection of babesiosis and Lyme disease, particularly in elderly patients with multiple comorbidities. Close monitoring and a multidisciplinary approach are essential for optimizing patient outcomes, particularly in elderly patients with complex comorbidities."

Clinical • Acute Kidney Injury • Alzheimer's Disease • Anemia • Cardiovascular • Cognitive Disorders • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hepatology • Hypertension • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases • Thrombocytopenia

ADDING FUEL TO THE FIRE: PNEUMOMEDIASTINUM, PNEUMOPERICARDIUM, AND BILATERAL PNEUMOTHORACES IN PNEUMOCYSTIS JIROVECII PNEUMONIA WITH CONCOMITANT POSITIVE AIRWAY-PRESSURE THERAPY (CHEST 2025) - "Biktarvy was initiated for HIV/AIDS along with Bactrim for PJP, which was confirmed with bronchoalveolar lavage after patient underwent diagnostic bronchoscopy...Diagnosis of PJP involves microbiologic identification of the organism in induced sputum or bronchoalveolar lavage, although, beta-D-glucan, LDH and clinical presentation can lead to presumptive diagnosis and guide treatment with Trimethoprim-Sulfamethoxazole or alternatives such as Atovaquone, Clindamycin with Primaquine, Trimethoprim with Dapsone or Pentamidine along with adjunctive steroids, if indicated... Severe PJP is associated with higher mortality in patients who develop respiratory complications such as hypoxemia and pneumothorax. Timely diagnosis, aggressive treatment with correct antimicrobials, and, if indicated, adjunctive glucocorticoids are all crucial to improving outcomes while providing supportive treatment. Further investigation into outcomes related to positive pressure ventilation and lung..."

Asthma • Cardiovascular • Cough • Fibrosis • Human Immunodeficiency Virus • Hypertension • Immunology • Infectious Disease • Inflammation • Obstructive Sleep Apnea • Pneumonia • Respiratory Diseases • Sleep Disorder • CD4

A Novel Series of Endochin-Like Quinolones (ASTMH 2025) - "Endochin-Like Quinolones (ELQs) are a new group of antiplasmodial compounds that target the plasmodial cytochrome bc1 complex, similarly to the currently used antimalarial atovaquone...We believe that ELQ-685 or another compound from this series could be a valuable back-up to ELQ-300, should drug resistance arise in the field. We here present data on in vitro and in vivo activity, metabolic stability, and pharmacokinetics of ELQ-685, and a structure activity relationship study of compounds within this series that has already identified compounds with high potency."

Late-breaking abstract • Infectious Disease • Malaria

Novel combination of PfCytB inhibitors shows promise for treatment of blood stage Plasmodium falciparum (ASTMH 2025) - "This synergy was maintained in strains with low to medium grade resistance to atovaquone. These data support atovaquone and ELQ-596 as a potential chemopreventive combination therapy to reduce the risk of multidrug resistance."

Infectious Disease • Malaria

MACROBID! THE SUBTLE LUNG POPPER? A CASE-BASED REPORT ON NITROFURANTOIN-INDUCED BILATERAL PNEUMOTHORAX (CHEST 2025) - "The patient also completed 5 days of azithromycin, 8 days of Zosyn, and 5 days of Meropenem to address concerns about secondary bacterial PNA and multidrug-resistant/atypical bacterial exposure.Upon the patient's most recent presentation to the ED, pulmonary examination revealed decreased breath sounds on the left side and diffuse bilateral crackles on auscultation...Prior to discharge, the patient was referred to Neurology for dysphagia and started on Atovaquone for pneumocystis pneumonia prophylaxis... Thank you!"

Clinical • Anorexia • Asthma • Endocrine Disorders • Fatigue • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Interstitial Lung Disease • Nephrology • Neuralgia • Pneumonia • Pulmonary Disease • Respiratory Diseases

UNMASKING THE UNCOMMON: CMV PNEUMONIA WITH CAVITARY ASPERGILLUS FUMIGATUS SUPERINFECTION IN ADVANCED HIV (CHEST 2025) - "Upon presentation, she was being treated for pneumonia and a urinary tract infection with Bactrim, Cefdinir, and Prednisone...The patient was started on Valganciclovir and Voriconazole with prophylactic Atovaquone, clinically improved, and was discharged home...Given the patient's history, the potential overlap of multiple opportunistic infections necessitated a broad-spectrum antimicrobial approach with Voriconazole and Ganciclovir, Atovaquone, and Biktarvy and close monitoring... This case highlights the diagnostic and therapeutic challenges in managing pulmonary infections in immunocompromised individuals. CMV pneumonia, though rare, should be considered in HIV patients with respiratory symptoms and cavitary lung lesions, particularly when other common etiologies are excluded. The presence of co-infections, such as Aspergillus fumigatus, further complicates treatment and underscores the importance of a multidisciplinary approach."

Metastases • Cardiovascular • Cytomegalovirus Infection • Human Immunodeficiency Virus • Infectious Disease • Leukopenia • Nephrology • Pneumonia • Pulmonary Embolism • Respiratory Diseases • Tuberculosis • CD4