system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 25-year-old male graduate student is brought to the emergency department for respiratory distress after he was found by his roommate coughing and severely short of breath. He was diagnosed with HIV infection 3 months ago but is not compliant with his antiretroviral therapy. He is from Chile and moved here 5 years ago. He appears unwell and is unable to speak in full sentences. His temperature is 38.2°C (100.7°F), pulse is 127/min, respirations are 32/min, and blood pressure is 95/65 mm Hg. Pulse oximetry shows an oxygen saturation of 86% on room air. No oral thrush is seen. The patient is placed on supplemental oxygen. Serum studies show:
Lactate dehydrogenase 364 IU/L
CD4 cell count 98/mm3
Beta-D-glucan elevated
Arterial blood gas analysis shows:
pH 7.50
PaCO2 22 mm Hg
PaO2 60 mm Hg
HCO3 20 mEq/L
An x-ray of the chest is shown. Standard antibiotic therapy is begun immediately. The most appropriate next step in management is administration of which of the following?"
assistant
Prednisone