Coexistence of Competing Opportunistic Pathogens in Critically ill Patients with Advanced AIDS: A Case Report and Literature Review

Seregey Voznesenskiy1, Tatyana Ermak2, Karl Emerole1, *, Еlena Samotolkina3, Polina Klimkova3, Evgeniya Abramova3, Galina Kozhevnikova1
1 Department of Infections Diseases, Рeoples’ Friendship University of Russia (RUDN University), Moscow, Russia
2 Central Research Institute of Epidemiology, Moscow, Russia
3 Infectious Diseases Clinical Hospital No 2 Moscow, Russia

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 1445
Abstract HTML Views: 603
PDF Downloads: 766
ePub Downloads: 334
Total Views/Downloads: 3148
Unique Statistics:

Full-Text HTML Views: 741
Abstract HTML Views: 388
PDF Downloads: 441
ePub Downloads: 238
Total Views/Downloads: 1808

Creative Commons License
© 2022 Voznesenskiy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Infections Diseases, Рeoples’ Friendship University of Russia (RUDN University), Moscow, Russia; E-mail:



Opportunistic infections (OIs) are the leading causes of morbidity and mortality among HIV-infected individuals. The incidence of OIs is greater in antiretroviral treatment (ART) naive patients. As of 30 June 2021, 28.2 (73%) people with HIV/AIDS (PLWHA) were accessing antiretroviral therapy (ART) globally, leaving the remaining 27% PLWHA without ART at risk for OIs. Multiple opportunistic infections are caused due to the coexistence of competing opportunistic pathogens that confound clinical manifestations, investigative procedures, and management protocols.

Case Presentation:

In this report, we describe the case of a critically ill HIV female patient admitted to the ICU. The patient was diagnosed with multiple opportunistic infections and subsequently died after her illness progressed. Due to the paucity of information on the subject, we conducted a retrospective study of 1440 case records of HIV/AIDS critically ill patients to determine the incidence and spectrum of multiple opportunistic infections. We performed a review of the available medical literature relevant to the subject.


Knowledge of such events would guide and enhance the physician's diagnostic and management strategies, especially in resource limited regions.

Keywords: HIV, Advanced AIDS, Opportunistic pathogens, Opportunistic infections, Coexistence, Intensive care unit.