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Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS.
N Y State J Med. 1992 Jul; 92(7):297-300.NY

Abstract

Purulent bronchitis was identified in 19 of 422 patients undergoing fiberoptic bronchoscopy during a 32-month period because of suspicion of an opportunistic lung infection complicating acquired immunodeficiency syndrome or human immunodeficiency virus infection. Five patients had Pneumocystis carinii pneumonia, but other opportunistic lung infections were excluded in the remaining 14 patients. Characteristics of these 14 patients included fever (greater than 38.3 degrees C), cough, and dyspnea in 14 of 14 patients; purulence of expectorated sputum (11/14); and widened alveolar-arterial oxygen gradient (13/14). Rapid (2 +/- 1.4 days) clinical response (defervescence and resolution of pulmonary symptoms) occurred with antibiotic therapy in 10 of 14 patients. In three patients, there was no improvement, and adult respiratory distress syndrome developed. Bacterial isolates from bronchoalveolar lavage included Streptococcus viridans (n = 12), Haemophilus influenzae (n = 7), Staphylococcus aureus (n = 3). Roentgenographic features of bronchiectasis were present in seven patients. Differential cell counts revealed greater than 50% neutrophils in the bronchial washings of all patients with purulent bronchitis. Neutrophil percentages in bronchoalveolar lavage were as follows: patient with purulent bronchitis without P carinii pneumonia (n = 14), 54.53% +/- 29.18%; patients with purulent bronchitis and concomitant P carinii pneumonia (n = 5), 62% +/- 31.9%. In a control group of 17 patients with P carinii pneumonia who did not have purulent bronchitis, the neutrophil percentage was 6.8% +/- 6.17% (p = less than 0.00001, t-test). Purulent bronchitis appears to be a distinct, treatable entity in patients with HIV infection and may accompany bacterial pneumonia, bronchiectasis, and P carinii pneumonia.

Authors+Show Affiliations

Chechani V
Department of Medicine, State University of New York Health Science Center, Kings County Hospital, Brooklyn.
Allam AA
No affiliation info available
Smith PR
No affiliation info available
Webber CA
No affiliation info available
Kamholz SL
No affiliation info available

MeSH

Acquired Immunodeficiency SyndromeAdultBronchiectasisBronchitisBronchoscopyDiagnosis, DifferentialFemaleHIV InfectionsHumansMaleMiddle AgedOpportunistic InfectionsPneumonia, PneumocystisRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1518586

Citation

Chechani, V, et al. "Bronchitis Mimicking Opportunistic Lung Infection in Patients With Human Immunodeficiency Virus Infection/AIDS." New York State Journal of Medicine, vol. 92, no. 7, 1992, pp. 297-300.
Chechani V, Allam AA, Smith PR, et al. Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS. N Y State J Med. 1992;92(7):297-300.
Chechani, V., Allam, A. A., Smith, P. R., Webber, C. A., & Kamholz, S. L. (1992). Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS. New York State Journal of Medicine, 92(7), 297-300.
Chechani V, et al. Bronchitis Mimicking Opportunistic Lung Infection in Patients With Human Immunodeficiency Virus Infection/AIDS. N Y State J Med. 1992;92(7):297-300. PubMed PMID: 1518586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bronchitis mimicking opportunistic lung infection in patients with human immunodeficiency virus infection/AIDS. AU - Chechani,V, AU - Allam,A A, AU - Smith,P R, AU - Webber,C A, AU - Kamholz,S L, PY - 1992/7/1/pubmed PY - 1992/7/1/medline PY - 1992/7/1/entrez SP - 297 EP - 300 JF - New York state journal of medicine JO - N Y State J Med VL - 92 IS - 7 N2 - Purulent bronchitis was identified in 19 of 422 patients undergoing fiberoptic bronchoscopy during a 32-month period because of suspicion of an opportunistic lung infection complicating acquired immunodeficiency syndrome or human immunodeficiency virus infection. Five patients had Pneumocystis carinii pneumonia, but other opportunistic lung infections were excluded in the remaining 14 patients. Characteristics of these 14 patients included fever (greater than 38.3 degrees C), cough, and dyspnea in 14 of 14 patients; purulence of expectorated sputum (11/14); and widened alveolar-arterial oxygen gradient (13/14). Rapid (2 +/- 1.4 days) clinical response (defervescence and resolution of pulmonary symptoms) occurred with antibiotic therapy in 10 of 14 patients. In three patients, there was no improvement, and adult respiratory distress syndrome developed. Bacterial isolates from bronchoalveolar lavage included Streptococcus viridans (n = 12), Haemophilus influenzae (n = 7), Staphylococcus aureus (n = 3). Roentgenographic features of bronchiectasis were present in seven patients. Differential cell counts revealed greater than 50% neutrophils in the bronchial washings of all patients with purulent bronchitis. Neutrophil percentages in bronchoalveolar lavage were as follows: patient with purulent bronchitis without P carinii pneumonia (n = 14), 54.53% +/- 29.18%; patients with purulent bronchitis and concomitant P carinii pneumonia (n = 5), 62% +/- 31.9%. In a control group of 17 patients with P carinii pneumonia who did not have purulent bronchitis, the neutrophil percentage was 6.8% +/- 6.17% (p = less than 0.00001, t-test). Purulent bronchitis appears to be a distinct, treatable entity in patients with HIV infection and may accompany bacterial pneumonia, bronchiectasis, and P carinii pneumonia. SN - 0028-7628 UR - https://www.unboundmedicine.com/medline/citation/1518586/Bronchitis_mimicking_opportunistic_lung_infection_in_patients_with_human_immunodeficiency_virus_infection/AIDS_ DB - PRIME DP - Unbound Medicine ER -