Herpes Simplex Virus, Cytomegalovirus, andPneumocystis jiroveciPneumonia in a Treatment-Naive HIV-Positive Patient with Pulmonary Alveolar Proteinosis: Case Report

Abstract

Infection with multiple pathogens concurrently has become less common since the introduction of potent antiretroviral agent and effective prophylactic agents. We describe a patient with pulmonary alveolar proteinosis (PAP) admitted with pneumonia who was found to have AIDS and diagnosed with Pneumocystis jiroveci pneumonia, human herpesvirus type 1 (HHV-1), and a concomitant cytomegalovirus viremia. Polymerase chain reaction viral load was used for diagnosis of HHV-1 and follow-up. The patient was treated with trimethoprim-sulfamethoxazole and ganciclovir and had a resolution of pneumonia. Since patients with PAP who are diagnosed as having AIDS could be concomitantly infected with multiple pathogens, rapid accurate diagnosis and treatment may have a positive effect on outcome.

Evaluation Frequency of Human Cytomegalovirus Resistance to Ganciclovir (UL97) in Patients with HIV, using High Resolution Melting Analysis, Kerman, Iran

“…CMV is a major cause of morbidity and mortality in patients with HIV in the United States. CMV infection causes disease in several organ systems, including the central nervous system (CNS) (chorioretinitis, encephalitis, polyradiculopathy, myelopathy) and the gastrointestinal (GI) tract (oral ulcers, esophagitis, hepatitis, colitis, intestinal perforation), as well as life-threatening adrenalitis and pneumonitis Arellano-Galindo et al [2][3][4]. Epidemiologic studies indicated that half of HIV patients which are affected by CMV; have symptoms including chorioretinitis, esophagitis, colitis, pneumonia, and central nervous system disease Gianella et al [5].…”