[Respiratory failure in a HIV seropositive heroin addict female].
A 31-year-old woman, heroin addict since ten years, and infected by the human immunodeficiency virus (HIV) since one year, was admitted to the intensive care unit for respiratory failure (PaO2 = 40 mmHg and PaCO2 = 14.8 mmHg, despite breathing pure oxygen). She had been followed up for 6 months for increasing dyspnoea due to chronic cor pulmonale for which no satisfactory explanation had been put forward. Artificial ventilation with 8 cmH2O positive end-expiratory pressure and 100% oxygen was completely inefficient. She died within a few hours. Postmortem lung biopsy revealed talc particles within interalveolar walls and alveolar macrophages as well as the expected alterations in blood vessels. Pulmonary hypertension due to talc microemboli is a well-known cause of respiratory failure in heroin addicts. Such a diagnosis should not be overlooked in a patient infected with HIV. Respiratory failure may not be only due to opportunist infections, or tumours related to the HIV infection.
Magnan
A
A
Service de Pneumologie, Hôpital Nord, Marseille.
Ottomani
A
A
Garbe
L
L
Arnaud
A
A
Manelli
J C
JC
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000473:pathology; D007275:Injections, Intravenous / Q000009:adverse effects; D008168:Lung / Q000473:pathology; D012131:Respiratory Insufficiency / Q000209:etiology*; D012646:Self Administration / Q000009:adverse effects; D013627:Talc / Q000009:adverse effects*
D013627:Talc