Document 0706
 DOCN  M94A0706
 TI    HIV related chronic reactive/suppurative airway disease: is CMV
       important?
 DT    9412
 AU    Parkin D; Pigott P; Dept. of HIV Medicine, Royal North Shore Hospital,
       St Leonards,; NSW.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:28 (abstract no. TC5).
       Unique Identifier : AIDSLINE ASHM5/94348949
 AB    We describe a case of HIV related chronic reactive/suppurative airway
       disease in a non smoking 47 year old man. He had longstanding HIV
       infection treated with sporadic AZT. His initial complication was
       Pneumocystis carinii pneumonia in May 1992. He represented in August
       1992 with a two month history of suppurative sinusitis, productive
       cough, increasing shortness of breath, lethargy, myalgias and sweats.
       CD4 Count was 280. Spirometry FEV 3.4, VC 3.6. Chest x-ray was clear.
       Sputum unhelpful. There was no response to oral antibiotics. Induced
       sputum in September 1992 showed an increased white cell count, but no
       pathogens. Respiratory function tests showed restriction with decreased
       DLCO. High dose Bactrim gave no improvement. In December 1992 he had
       persisting symptoms and chest signs. Spirometry FEV 2.1, VC 2.9. Chest
       x-ray was unchanged. He responded to antibiotic and steroid. There were
       further relapses in February, March, April and May 1993, each time
       responding to steroid and antibiotic and requiring maintenance oral
       steroid. Admission was required in June 1993, for increasing shortness
       of breath and cough. He had diffuse respiratory signs and hypoxia.
       Bronchial biopsy revealed CMV. This case highlights the problem of
       chronic reactive/suppurative airway disease in HIV and raises the
       possibility of CMV being a contributing factor.
 DE    AIDS-Related Opportunistic Infections/*DIAGNOSIS/PATHOLOGY  Biopsy  Case
       Report  Cytomegalovirus Infections/*DIAGNOSIS/PATHOLOGY  Diagnosis,
       Differential  Human  Lung/PATHOLOGY  Male  Middle Age  Pneumonia,
       Viral/*DIAGNOSIS/PATHOLOGY  MEETING ABSTRACT

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