A Persistent Cough and an Unexplained Diagnosis - Takeaways - MDSpire

A Persistent Cough and an Unexplained Diagnosis

NEJM case details the diagnostic evaluation of an 80-year-old woman with weeks of respiratory symptoms, weight loss, and diffuse ground-glass opacities on chest CT.

  • By

  • Olivia Anderson

  • February 2, 2026

  • 3 min

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  • 1

    An 80-year-old woman was diagnosed with advanced HIV-1 infection complicated by Pneumocystis jirovecii pneumonia and cryptococcal pneumonia.

  • 2

    The patient presented with a productive cough, weight loss, and hypoxemia, with an oxygen saturation of 83% on ambient air.

  • 3

    Initial tests for common respiratory pathogens were negative, and empirical treatment for pneumonia did not improve her condition.

  • 4

    HIV testing revealed advanced infection with a viral load of 223,000 copies per milliliter and a CD4 count of 33 per microliter.

  • 5

    The case highlights the need for HIV risk assessment and screening in older adults, as many are diagnosed at an advanced disease stage.

Original Source(s)

A Persistent Cough and an Unexplained Diagnosis

  • by Olivia Anderson

  • February 2, 2026

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