Denis M, Chouaid C, Cadranel J, Gonzales G, Mayaud C; International Conference on AIDS.

Int Conf AIDS. 1991 Jun 16-21; 7: 221 (abstract no. M.B.2158).

Rothschild, St Antoine Hospital, Paris, France

The objective of this retrospective study is to analyse the frequency, the pathogens responsible and the clinical data of pleural effusion (P.E) due to opportunistic infection (O.P.E) in AIDS pts. Incidence and responsible pathogens: between 1988 and 1990, 75 HIV-infected pts were admitted to the East Paris Hospitals because of P.E. The underlying cause of P.E was formally established in 61 cases (81%), opportunistic agents being responsible for 6 cases (8%). The pathogens were Cryptococcus neoformans (CN) (n=3), Leishmania donovani (LD) (n=1) and Pneumocystis Carinii (PC) (n=2). Clinical presentation: O.P.E was observed in 6 men, average age 38 (34-46), homosexuals (n=5) and an I.V drug addict (n=1). At the onset of O.P.E, HIV infection had been previously diagnosed in 4 pts who were in G II (n=2), G III (n=1) or G IV CID (n=1) of the CDC classification. O.P.E led to diagnosis of HIV infection in the other two. Except for the pt infected by LD, the CD4 lymphocyte count was less than 20/mul. The main clinical data were: progressive onset greater than 10 days (n=6); temperature greater than 39 degree C (CN: n=2, PC: n=1) or less than 38 degree C (PC: n=1, CN: n=1, LD: n=1); associated pneumonia (PC: n=2; CN: n=1, LD: n=1), meningitis (CN: n=1) and/or mediastinal adenopathy (PC: n=1, LD: n=1). Diagnosis: cryptococcosis (n=3) was diagnosed by thoracocentesis (specific antigen and positive culture in pleural fluid). Thoracotomy was needed for diagnosis of leishmaniasis or pneumocystosis (positive biopsies). Evolution: In all cases, favorable evolution was observed due to specific treatment: I. V pentamidine for pneumocytosis; amphotericin B for cryptococcosis; glucantime for leishmaniasis. CONCLUSION: In the literature, Kaposi's sarcoma and tuberculosis are the usual causes of progressive P.E. Our study clearly shows that opportunistic infection may also be at cause particularly in pts with a low CD4 lymphocyte count.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Amphotericin B
• CD4 Lymphocyte Count
• Cryptococcosis
• Cryptococcus neoformans
• HIV Infections
• HIV Seropositivity
• Humans
• Incidence
• Male
• Opportunistic Infections
• Paris
• Pleural Effusion
• Pneumonia, Pneumocystis
• Retrospective Studies
• Sarcoma, Kaposi

Other ID:

• 1215891

UI: 102183081

From Meeting Abstracts