Sinusitis in human immunodeficiency virus infection: typical and atypical organisms.
The majority of patients with human immunodeficiency virus (HIV) infection will develop acute sinusitis. This may be a single episode, or may be the beginning of a long course of recurrent sinusitis, of which the etiology is not yet well understood. A retrospective study of cultures from antral washings was conducted to determine the organisms that were more commonly isolated in patients with HIV infection and sinusitis. Forty-seven organisms were isolated from the sinus cultures of 41 HIV-positive patients. The most common organisms isolated were Streptococcus pneumoniae (19%), Streptococcus viridans (19%), and Pseudomonas aeruginosa (17%). Pseudomonas aeruginosa is an atypical cause of acute sinusitis in the general population but was found to be an important pathogen in our HIV-infected patients. Other atypical organisms were also isolated, including Listeria monocytogenes and Candida albicans. It is important to recognize that atypical organisms must be considered if an HIV-infected patient with sinusitis does not respond to initial antibiotic therapy. A discussion follows emphasizing the need for prompt diagnosis and treatment of sinusitis in HIV infection.
Milgrim
L M
LM
Department of Otolaryngology, Montefiore Medical Center, Bronx, New York 10467.
Rubin
J S
JS
Rosenstreich
D L
DL
Small
C B
CB
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008297:Male; D010256:Paranasal Sinuses / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents