       Document 0807
 DOCN  M94B0807
 TI    Bacterial bronchitis and bronchiectasis in human immunodeficiency virus
       infection.
 DT    9412
 AU    Verghese A; al-Samman M; Nabhan D; Naylor AD; Rivera M; Division of
       Infectious Diseases, Texas Tech University Health; Sciences Center, El
       Paso.
 SO    Arch Intern Med. 1994 Sep 26;154(18):2086-91. Unique Identifier :
       AIDSLINE MED/94379881
 AB    BACKGROUND: Bacterial pneumonia and sinusitis are important causes of
       morbidity in patients with human immunodeficiency virus (HIV) infection.
       We noted an increased incidence of bacterial bronchitis and
       bronchiectasis in our patients with HIV infection. METHODS: This study
       was conducted on persons with HIV infection at a county hospital and
       clinic. Bronchiectasis was diagnosed by bronchogram and computed
       tomography in one patient and by computed tomography alone in two
       others. Bacterial bronchitis was defined by a Gram's stain showing an
       abundance of neutrophils with a predominance of one or more bacteria and
       by a confirmatory sputum culture. Bronchoscopy with broncho-alveolar
       lavage was performed in patients with bronchitis to eliminate other
       causes of bronchial inflammation. RESULTS: Eighteen episodes of
       bacterial bronchitis in 10 patients are described. The mean CD4
       lymphocyte counts for these patients was 0.061 x 10(9)/L (range, 0.001
       to 0.203 x 10(9)/L). The most common pathogens in 18 episodes of
       bacterial bronchitis were Haemophilus influenzae and Streptococcus
       pneumoniae (five episodes each) and Pseudomonas aeruginosa (four
       episodes). Response to antibiotic therapy was usually rewarding though
       recurrences were frequent. Three patients with well-defined
       bronchiectasis who appeared to have developed, or who became symptomatic
       during the course of, HIV infection are described. Their mean CD4 cell
       count was 0.03 x 10(9)/L (range, 0.024 to 0.037 x 10(9)/L). Haemophilus
       influenzae, Staphylococcus aureus, Pseudomonas cepacia, and P aeruginosa
       were recovered from these patients; the P aeruginosa was a mucoid
       strain. CONCLUSIONS: Recurrent bacterial bronchitis should be added to
       the list of bacterial infections that occur with increased frequency
       with HIV infection. Repeated bacterial bronchitis may lead to
       bronchiectasis, which may be more common in HIV infection than generally
       appreciated.
 DE    Adult  Bronchiectasis/*MICROBIOLOGY
       Bronchitis/*COMPLICATIONS/*MICROBIOLOGY  Case Report  Female  Human  HIV
       Infections/*COMPLICATIONS  Male  Recurrence  Support, Non-U.S. Gov't
       JOURNAL ARTICLE  REVIEW  REVIEW OF REPORTED CASES

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

