Pulmonary Manifestations of Acquired Immunodeficiency Syndrome

Meduri, Gianfranco U.; Stein, Daniel S.

doi:10.1093/clinids/14.1.98

Cited by 73 publications

(24 citation statements)

References 90 publications

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“…According to results of autopsy findings, the lung was affected with an incidence ranging from 100% in the early period of the epidemic to 70% in the HAART era [7][8][9][10][11]. Up to 70% of HIV patients have a pulmonary complication during the evolution of the disease, mainly of infectious aetiology [11].…”

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confidence: 99%

Pulmonary infections in HIV-infected patients: an update in the 21st century

Benito¹,

Moreno²,

Miró³

et al. 2011

European Respiratory Journal

176

216

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From the first descriptions of HIV/AIDS, the lung has been the site most frequently affected by the disease. Most patients develop a pulmonary complication during the history of HIV infection, mainly of infectious aetiology.Important changes in the epidemiology of HIV-related pulmonary infections have occurred. Overall, prescription of Pneumocystis jirovecii prophylaxis and the introduction of highly active antiretroviral therapy (HAART) are the main causes.Currently, the most frequent diagnosis in developed countries is bacterial pneumonia, especially pneumococcal pneumonia, the second most frequent cause is Pneumocystis pneumonia and the third is tuberculosis. However, in Africa, tuberculosis could be the most common pulmonary complication of HIV.Pulmonary infections remain one of the most important causes of morbidity and mortality in these patients, and the first cause of hospital admission in the HAART era. Achieving an aetiological diagnosis of pulmonary infection in these patients is important due to its prognostic consequences.

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confidence: 99%

Pulmonary infections in HIV-infected patients: an update in the 21st century

Benito¹,

Moreno²,

Miró³

et al. 2011

European Respiratory Journal

176

216

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“…In neutropenic patients, mainly patients with hematological malignancies and bone marrow transplant recipients, bacterial and fungal pneumonia is the most important challenge (1,9). On the other hand, in HIV-infected patients P. carinii remains a common respiratory pathogen together with Streptococcus pneumoniae and Mycobacterium tuberculosis (22)(23)(24).…”

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confidence: 99%

Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol

Danés¹,

González-Martín²,

Pumarola³

et al. 2002

J Clin Microbiol

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A diagnostic protocol was started to study the etiology of pulmonary infiltrates in immunosuppressed patients. The diagnostic yields of the different techniques were analyzed, with special emphasis on the importance of the sample quality and the role of rapid techniques in the diagnostic strategy. In total, 241 patients with newly developed pulmonary infiltrates within a period of 19 months were included. Noninvasive or invasive evaluation was performed according to the characteristics of the infiltrates. Diagnosis was achieved in 202 patients (84%); 173 patients (72%) had pneumonia, and specific etiologic agents were found in 114 (66%). Bronchoaspirate and bronchoalveolar lavage showed the highest yields, either on global analysis (23 of 35 specimens [66%] and 70 of 134 specimens [52%], respectively) or on analysis of each type of pneumonia. A tendency toward better results with optimal-quality samples was observed, and a statistically significant difference was found in sputum bacterial culture. Rapid diagnostic tests yielded results in 71 of 114 (62.2%) diagnoses of etiological pneumonia.

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“…Other studies have also suggested that transbronchial biopsy is not routinely necessary in people with AIDS unless there is a suspicion of neoplasia or an endobronchial lesion. 1,3,10 Also, biopsy may result in additional complications, such as pneumothorax, hemorrhage, arrhythmias or pneumonia and adds to the cost of patient care. 3 The mean CD4 + lymphocyte count was lower in patients with an identified pathogen (34 cells/mm 3 ) than those with nonspecific diagnoses (87 cells/mm 3 ) (P < .002).…”

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confidence: 99%