Document 0041
 DOCN  M9590041
 TI    [Pneumopathies caused by Streptococcus pneumoniae in 27 HIV infected
       patients]
 DT    9509
 AU    Duval X; Paty MC; Longuet P; Lacassin F; Perronne C; Leport C; Vilde JL;
       Service des Maladies infectieuses et tropicales, Hopital; Bichat-Claude
       Bernard, Paris.
 SO    Presse Med. 1995 Apr 15-22;24(15):715-8. Unique Identifier : AIDSLINE
       MED/95303854
 AB    OBJECTIVES: Determine the clinical features and outcome of acute
       pneumonia due to Streptococcus pneumoniae in HIV infected patients
       compared with non-HIV infected patients. METHODS: From January 1986 to
       February 1992, we observed 33 episodes of pneumococcal pneumonia in 27
       HIV-infected patients. Most of the patients were drug addicts (16/27),
       and/or originated from Central Africa or Haiti (10/27). In 9/27 (33%)
       patients, HIV infection was previously unknown. Eleven of the 27
       patients were at the CDC stages II-III and CD4 cell count was greater
       than 200/mm3 and CD8 cell count was greater than 1000/mm3 in 12/23
       patients and 10/20 patients respectively. RESULTS: In 10/33 episodes,
       respiratory symptoms were severe: bilateral pneumonia (n = 2) and/or
       hypoxaemia (n = 9). In 22/33 episodes, hospitalization occurred less
       than 24 h after the onset of symptoms and in 9/33 episodes, the initial
       chest X-ray was normal. Streptococcus pneumoniae was isolated in 16/33
       episodes, from blood (n = 10), bronchoalveolar lavage (n = 3) or sputum
       (n = 3). Penicillin G or amoxicillin was used and allowed a favorable
       and quick response in all episodes. Recurrence occurred in 5/18 (27%)
       followed patients. These recurrences were not favoured by a low CD4 cell
       count since it was more than 200/mm3 in these five patients. However,
       the mean count of CD8 cells was higher in patients with recurrence than
       in patients without recurrence, 1990/mm3 versus 995/mm3 (p = 0.03).
       CONCLUSION: CD8 hyperlymphocytosis could increase the risk of recurrence
       and would help identify a subgroup with higher risk of pneumococcal
       pneumonia among HIV infected persons.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adolescence  Adult
       Amoxicillin/ADMINISTRATION & DOSAGE/THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/*COMPLICATIONS/DRUG THERAPY  English Abstract
       Female  Human  HIV Infections/*COMPLICATIONS  Infusions, Intravenous
       Male  Middle Age  Penicillin G/ADMINISTRATION & DOSAGE/THERAPEUTIC USE
       Pneumonia, Lobar/*COMPLICATIONS/DRUG THERAPY  Recurrence  Retrospective
       Studies  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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