Pleural fluid findings in patients with the acquired immunodeficiency syndrome: correlation with concomitant pulmonary disease.
BACKGROUND
We sought to define the spectrum of conditions associated with pleural effusion (PE) in patients with the acquired immunodeficiency syndrome (AIDS) who submitted to diagnostic thoracentesis.


METHODS
The medical records of patients with human immunodeficiency virus (HIV) infection and PE studied by thoracentesis over a 5-year period, were reviewed for demographics, clinical presentation, concomitant illnesses, pleural fluid analysis, management, and outcome.


RESULTS
Thoracentesis was done in 30 patients, 24 men and 6 women, with an overall mean age of 36 +/- 9 years. Mean CD4 cell count was 157 +/- 249/mm3. The cause of the PE was infectious in 21 (70%) and noninfectious in 9 (30%). Bacterial pneumonia was the most common cause of PE (57%). Streptococcus pneumoniae and Staphylococcus aureus were the major organisms recovered. Mycobacterial infections were present in 3 patients, and Nocardia sp was isolated from 1 patient. Non-Hodgkin's lymphoma (5 cases) was the leading noninfectious cause of PE, followed by Kaposi's sarcoma (3 cases) and adenocarcinoma of the lung (1 case). Twelve of the 30 patients died during hospitalization.


CONCLUSIONS
Pleural effusion is an important problem in patients with advanced HIV infection. It is most frequently associated with bacterial pneumonia. Cytologic and microbiologic examination of the pleural fluid is helpful in determining the cause of PE in this patient population.
Soubani
A O
AO
Department of Medicine, University of Alabama School of Medicine, USA.
Michelson
M K
MK
Karnik
A
A
D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D018410:Pneumonia, Bacterial / Q000150:complications*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification