HIV related chronic reactive/suppurative airway disease: is CMV important?

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

HIV related chronic reactive/suppurative airway disease: is CMV important?

Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:28 (abstract no. TC5). Unique Identifier : AIDSLINE ASHM5/94348949
Parkin D; Pigott P; Dept. of HIV Medicine, Royal North Shore Hospital, St Leonards,; NSW.

Abstract: 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.

Keywords: 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 ABSTRACT
941230
M94C4278

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