Lacassin F, Leport C, Gehanno P, Salmon D, Raguin G, Bricaire F, Vilde JL; International Conference on AIDS.
Int Conf AIDS. 1990 Jun 20-23; 6: 210 (abstract no. F.B.528).
Hopital Claude Bernard - Bichat, Paris, France
OBJECTIVES: To assess clinical presentation, and outcome of sinusitis in HIV infected patients. METHODS: From 06/1986 to 11/1989, the charts of patients (pts) treated for sinusitis were reviewed. An acute episode (ep) of sinusitis was diagnosed when an opacity, an air fluid level, or a mucosal thickening was present on sinus X-Ray. All had clinical signs consistent with sinusitis and/or a favorable response to antimicrobial treatment i.e. improvement of sinus X-Ray. RESULTS: Twenty-nine eps were diagnosed in 20 pts, 18 men and 2 women, mean age: 35 years (24-56). Ten pts were classified as ARC and 10 as AIDS, mean CD4 cell count was 162/mm3 (3-662) (n=16). Clinical signs, present for a mean duration of 41.5 days (0-5 months) (mths) were: fever (73%), headache (61%), purulent nasal discharge (51.5%), nasal obstruction (39%), sinusal pain (33%); cough was present in 88% and sputum in 48%. Concomitant pneumonia was detected in 28%. In 12 pts, brain CT scan confirmed abnormalities of sinus X-Ray and detected ethmoidal (n=2) and/or sphenoidal (n=2) sinusitis in 3 pts (25%). Maxillary sinusitis was present in 22 (76%) eps, frontal sinusitis in 2 (7%), and pansinusitis in 5 (17%). Bacteria were isolated from upper airways in 8/29 eps (28%), of which sinus puncture, positive in 3/3 pts, grew Haemophilus influenzae (n=1), Pseudomonas aeruginosa (n=1) and 3 different strains in 1 pt. From broncho alveolar lavage, sputum, or nasal discharge were isolated: H.influenzae (n=4), S.Pneumoniae (n=1). Antimicrobials were ampicillin alone (22%) or combined with clavulanic acid (40%), fluoroquinolones (18%), macrolides (11%) for a mean duration of 23 days (8-51). A surgical drainage was performed in 4 cases. Ten clinical relapses occurred in 8/20 pts (40%) within 2 mths (0-13) after the end of antimicrobial therapy. Final outcome was remission in 15 pts with a mean follow up of 11 mths (1-29), chronic sinusitis in 4 pts with a mean follow up of 12 mths (1-19). CONCLUSION: The diagnosis of sinusitis should be considered in HIV pts and may require sinus puncture for bacteriologic documentation. The high rate of relapse suggests a more prolonged and aggressive initial therapy.
Publication Types:
Keywords:
- AIDS Vaccines
- AIDS-Related Complex
- Acquired Immunodeficiency Syndrome
- Anti-Bacterial Agents
- Anti-Infective Agents
- Clavulanic Acid
- Female
- Fluoroquinolones
- Frontal Sinusitis
- HIV Infections
- HIV Seropositivity
- Haemophilus Infections
- Haemophilus influenzae
- Humans
- Male
- Maxillary Sinusitis
- Paranasal Sinuses
- Sinusitis
- microbiology
Other ID:
UI: 102184452
From Meeting Abstracts