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M94B0807.TXT
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1994-11-11
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Document 0807
DOCN M94B0807
TI Bacterial bronchitis and bronchiectasis in human immunodeficiency virus
infection.
DT 9412
AU Verghese A; al-Samman M; Nabhan D; Naylor AD; Rivera M; Division of
Infectious Diseases, Texas Tech University Health; Sciences Center, El
Paso.
SO Arch Intern Med. 1994 Sep 26;154(18):2086-91. Unique Identifier :
AIDSLINE MED/94379881
AB BACKGROUND: Bacterial pneumonia and sinusitis are important causes of
morbidity in patients with human immunodeficiency virus (HIV) infection.
We noted an increased incidence of bacterial bronchitis and
bronchiectasis in our patients with HIV infection. METHODS: This study
was conducted on persons with HIV infection at a county hospital and
clinic. Bronchiectasis was diagnosed by bronchogram and computed
tomography in one patient and by computed tomography alone in two
others. Bacterial bronchitis was defined by a Gram's stain showing an
abundance of neutrophils with a predominance of one or more bacteria and
by a confirmatory sputum culture. Bronchoscopy with broncho-alveolar
lavage was performed in patients with bronchitis to eliminate other
causes of bronchial inflammation. RESULTS: Eighteen episodes of
bacterial bronchitis in 10 patients are described. The mean CD4
lymphocyte counts for these patients was 0.061 x 10(9)/L (range, 0.001
to 0.203 x 10(9)/L). The most common pathogens in 18 episodes of
bacterial bronchitis were Haemophilus influenzae and Streptococcus
pneumoniae (five episodes each) and Pseudomonas aeruginosa (four
episodes). Response to antibiotic therapy was usually rewarding though
recurrences were frequent. Three patients with well-defined
bronchiectasis who appeared to have developed, or who became symptomatic
during the course of, HIV infection are described. Their mean CD4 cell
count was 0.03 x 10(9)/L (range, 0.024 to 0.037 x 10(9)/L). Haemophilus
influenzae, Staphylococcus aureus, Pseudomonas cepacia, and P aeruginosa
were recovered from these patients; the P aeruginosa was a mucoid
strain. CONCLUSIONS: Recurrent bacterial bronchitis should be added to
the list of bacterial infections that occur with increased frequency
with HIV infection. Repeated bacterial bronchitis may lead to
bronchiectasis, which may be more common in HIV infection than generally
appreciated.
DE Adult Bronchiectasis/*MICROBIOLOGY
Bronchitis/*COMPLICATIONS/*MICROBIOLOGY Case Report Female Human HIV
Infections/*COMPLICATIONS Male Recurrence Support, Non-U.S. Gov't
JOURNAL ARTICLE REVIEW REVIEW OF REPORTED CASES
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).