Abstract
Aims and Objectives: To study the clinical manifestations and course of disseminated bacterial community-acquired pneumonia (DBCAP) in patients with advanced HIV infection and immunosuppression.
Methods: 22 patients, aged 20-60, with DBCAP caused by S. pneumoniae with HIV infection at 4B stage in progression phase and without antiretroviral therapy were under observation. In 9 (40.9%) out of 20 cases, DBCAP was combined with other secondary diseases and in 18 (81.2%) cases with drug addiction and viral hepatitis B or C.
Results: In 14 (63.6%) patients with DBCAP, CD4 + CLYM averaged 57c/μl (ranged from 18 to 85). An intoxication syndrome and bronchopulmonary disease manifestations were moderately expressed, and CT of the respiratory organs revealed an ambilateral multisegmental lesion, foci of medium and large sizes (3-10 mm in diameter) with a tendency to merge and form small infiltrates, against the background of which bronchi lumen were revealed. In 8 (36.4%) cases, CD4 + CLYM averaged 19.5 c/μl (ranged from 10 to 45). They had a severe intoxication syndrome and bronchopulmonary manifestations. Secondary diseases symptoms (mucocutaneous candidiasis in 7 cases, cytomegalo and herpes virus infection in 5, toxoplasmosis in 2), as well as diarrhea, weight loss, peripheral and intrathoracic polylimfoadenopathy, neuropathy and encephalopathy were reported and CT revealed small-sized abscesses.
Conclusions: DBCAP in patients with advanced HIV infection is characterized by a severe immunosuppression with CD4+ CLYM less than 60 c/μl and an ambilateral multisegmental focal pneumonia with a tendency to merge, revealed by CT and with CD4+ CLYM less than 20- with formation of small-sized abscesses.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4545.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019