A person died of HIV infection. Lung Autopsy performed in this person showed intranuclear basophilic inclusions. His CD4 count was less than 100/uL. Which is the most probable diagnosis?
A person died of HIV infection. Lung Autopsy performed in this person showed intranuclear basophilic inclusions. His CD4 count was less than 100/uL. Which is the most probable diagnosis?
💡 Explanation
## **Core Concept**
The question involves an HIV-infected individual with a severely compromised immune system, as indicated by a CD4 count of less than 100/uL. This patient has developed an opportunistic infection, which is common in immunocompromised individuals. The presence of intranuclear basophilic inclusions in the lung autopsy is a critical finding for diagnosing the specific opportunistic infection.
## **Why the Correct Answer is Right**
The correct answer, **CMV (Cytomegalovirus) pneumonia**, is supported by the presence of intranuclear basophilic inclusions, also known as "owl's eye" appearance, which is characteristic of CMV infection. CMV is an opportunistic pathogen that causes severe disease in immunocompromised individuals, especially those with HIV/AIDS and a CD4 count below 100/uL. CMV pneumonia is a well-known complication in such patients, and the histopathological finding of intranuclear inclusions is diagnostic.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is blank and cannot be evaluated.
- **Option B:** This option is blank and cannot be evaluated.
- **Option D:** This option is blank and cannot be evaluated.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that CMV disease, including pneumonia, typically occurs in HIV-infected individuals with a CD4 count below 100/uL. The presence of intranuclear basophilic inclusions is pathognomonic for CMV infection. Clinicians should consider CMV disease in the differential diagnosis of opportunistic infections in severely immunocompromised HIV patients.