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Ask the Experts about Opportunistic Infections

 

pcp
Sep 1, 2000

My son was just dx with pcp. He doesn't have a fever and was prescribed an ABT and released. He was so weak that we had to almost carry him to the car. The MD in charged was rude and insulting to my son and called him a liar d/t not being able to take the cocktail. The MD did not even come to the room to release him. The nurse in charge did this. I'm so confused. My son doesn't have insurance and I feel that this was the reason he was released. Was he released too soon? By the way......he was in John Sealy in Galveston. They did not have a viral floor d/T cut backs. I am a nurse of only 1 year and the knowledge I have obtained has just gone out the window because this is my son. He won't come back home because he feels like family members just sit and watch him die. I really need to know point blank about PCP. I'm far from being a stupid woman but I am a mother. This is my baby and I wished I could take this from him everyday and carry it myself. Please help me.

Response from Dr. Feinberg

PCP can be treated on an outpatient basis if the person is clinically stable and has a good oxygen level in his blood, ideally over 90% (this can be tested by a blood gas, which isn't pleasant, or by an oxygen saturation meter). If the patient desaturates significantly with exercise (like walking a flight of stairs), then I usually put them in the hospital until they are doing better. Being too weak to walk may mean that he could have benefitted from a longer stay in the hospital. If he is short of breath or gets winded easily with little physical effort, he may be better off back in the hospital where he can be watched more closely.

There are many ways of constructing an effective antiviral "cocktail" and if you son had trouble with one, there are other possible combinations he can try. It sounds like he needs a more sympathetic doctor who will work with him to get him better. I am not familiar with John Sealy Hospital, but there are good HIV doctors at UT Galveston. Perhaps you should try there. Good luck!



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