A 30-year-old female with advanced human immunodeficiency virus (HIV) type 1 infection was transferred to our institution for evaluation of persistent cough and recurrent fevers of unknown origin. She had immigrated from the Philippines to the United States 3 years ago and first came to medical attention at an outside institution 12 weeks prior to current presentation after experiencing 2 months of cough, night sweats, and fevers. Testing at that time revealed Pneumocystis jirovecii pneumonia (PJP) and HIV infection, with an HIV load of 210,000 copies/mL and a CD4 T lymphocyte count of 13 cells/μL (reference range, 500 to 1,200 cell/μL). She was hospitalized for 7 days and treated with trimethoprim-sulfamethoxazole and prednisone for PJP, which was later switched to atovaquone after she developed acute kidney injury (AKI). She was also started on a combination antiretroviral therapy (ART) of bictegravir, emtricitabine, and tenofovir alafenamide for HIV infection.

A 30-year-old female with advanced human immunodeficiency virus (HIV) type 1 infection was transferred to our institution for evaluation of persistent cough and recurrent fevers of unknown origin. She had immigrated from the Philippines to the United States 3 years ago and first came to medical attention at an outside institution 12 weeks prior to current presentation after experiencing 2 months of cough, night sweats, and fevers. Testing at that time revealed Pneumocystis jirovecii pneumonia (PJP) and HIV infection, with an HIV load of 210,000 copies/mL and a CD4 T lymphocyte count of 13 cells/μL (reference range, 500 to 1,200 cell/μL). She was hospitalized for 7 days and treated with trimethoprim-sulfamethoxazole and prednisone for PJP, which was later switched to atovaquone after she developed acute kidney injury (AKI). She was also started on a combination antiretroviral therapy (ART) of bictegravir, emtricitabine, and tenofovir alafenamide for HIV infection.