Cavitary pulmonary lesions associated with Flavimonas oryzihabitans in a patient with HIV Infection.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10234)
Newell L, Natarajan U, Curtis S, Churchill DR Elton John Centre, Brighton General Hospital, Brighton, United Kingdom
Case report: A 33 year old HIV-positive gay man presented with a 3 week history of productive cough, fever and pleuritic chest pain. He was on no medication. On examination, he was febrile, had a tachycardia, oral thrush and had signs of left-sided pulmonary consolidation. His CD4+ lymphocyte count was 230/mm3, and his plasma HIV RNA was 83,100 copies/ml. Arterial blood gases showed no hypoxia. A chest radiograph showed a large left-sided lung abscess, and multiple cavitary lesions in both lungs. Cultures of blood and sputum were negative for bacteria and mycobacteria. Bronchoscopy was negative for Pneumocystis. He failed to respond to broad-spectrum antibiotics, and underwent tube drainage of his lung abscess. After 16 days in hospital, culture of pus from the abscess grew Flavimonas oryzihabitans. He was then treated with intravenous imepenem, which led to resolution of his fever and the lung abscess. Discussion: Flavimonas oryzihabitans has previously been reported as an unusual cause of community-acquired pneumonia in immunocompromised individuals, including those with HIV infection. Cavitation associated with this organism has not previously been reported.
Keywords: AEGIS, HIV Infections, Lung Abscess, CD4 Lymphocyte Count, Pseudomonas, Pneumonia, Immunocompromised Host, Anti-Bacterial Agents, Human, Male, immunology
