Pseudomonas aeruginosa bronchopulmonary infection in patients with advanced human immunodeficiency virus disease

Abstract

Pseudomonas aeruginosa is increasingly reported as a respiratory pathogen in patients with advanced human immunodeficiency virus (HIV) disease. We retrospectively reviewed the chest radiographic appearances of 29 HIV-infected adults with bronchopulmonary infection in whom Pseudomonas aeruginosa was the sole respiratory pathogen isolated. The commonest radiographic abnormality was a diffuse reticular (11 patients) or reticulonodular (9 patients) infiltrate in the pulmonary interstitium. Alveolar opacification was seen in seven patients. Cavitation was rare (2 patients), as was ground-glass opacification (2 patients). Five patients had pleural effusions. No patient had mediastinal or hilar lymphadenopathy. Normal chest radiographs were seen in eight patients. Although the radiographic appearances of Pseudomonas bronchopulmonary infection in HIV-infected patients are non-specific, an interstitial infiltrate is a common finding. Pseudomonas aeruginosa should be considered along with the commoner pathogen Pneumocystis carinii in the differential diagnosis of an interstitial infiltrate in this group of patients.

HIV-related bronchopulmonary infection by pseudomonas aeruginosa in the HAART era: radiological findings

“…A variety of non-specific radiographic patterns has been noted in HIV+ patients with P. aeruginosa bronchopulmonary infection. More commonly, pneumonia appears as alveolar opacification (5,11), with lobar consolidation in 38% of cases (21); interstitial infiltrates, reticular, reticulonodular, and/or bronchial wall thickening were less frequently reported as predominant patterns (23).…”

“…The incidence of cavitation during P. aeruginosa pneumonia in HIV has been reported to be from 0 to 64% (5,8,21,23). The bronchopneumonias observed in our study were cavitated in 25% of the cases (6/24), and the frequency of cavitation was related to both CD4 cell count and HAART treatment, since cavities occurred to a higher proportion in subjects with CD4 v200/mm 3 (66%, 4/6) than in those not receiving HAART (83%, 5/6), but these differences were not significant (Pw0.05).…”

“…Bronchopulmonary infection with P. aeruginosa presents a variety of chest radiographic appearances, including normal chest radiographs. These observations are often confused by co-infection with other pathogens (5,8,11,17,21,23). Unfortunately, very little information exists on their radiological patterns in the HAART era.…”

Characterization of the poxAB Operon Encoding a Class D Carbapenemase in Pseudomonas aeruginosa,

“…P. aeruginosa however, is one of the leading causes of pneumonia in HIV patients (103)(104)(105)(106) and a common respiratory pathogen in patients with AIDS, where pulmonary and respiratory disease infections are often chronic and intractable (107)(108)(109)(110)(111).…”