HIV-related bronchopulmonary infection by Pseudomonas aeruginosa in the HAART era: radiological findings.
OBJECTIVE
To evaluate whether highly active antiretroviral therapy (HAART) modifies radiographic appearances of Pseudomonas aeruginosa bronchopulmonary infection in HIV-infected patients. P. aeruginosa is increasingly reported as a respiratory pathogen in HIV+ patients with very low levels of CD4 lymphocytes. Few studies have analyzed the radiological presentation of bronchopulmonary disease that occurs in HAART-treated patients.


METHODS
We retrospectively reviewed the chest radiographs of 46 HIV-infected patients with bronchopulmonary diseases in which P. aeruginosa was the sole respiratory pathogen that was isolated. All cases were community-acquired infection. Twenty-four of the patients were on HAART treatment, and 22 were not. Chest radiographs were assessed for the presence and distribution of parenchymal consolidation, reticular or reticulonodular infiltrates, bronchial wall thickening, ground-glass opacities, cavitation, pleural effusion, and adenopathies. Statistical analysis was done using Epi-Info version 6 (CDC, Atlanta, GA, USA).


RESULTS
Normal chest radiographs were observed in 11 patients. Eight of these 11 (73%) were receiving HAART, and 3/11 (27%) were not. The most common radiographic abnormality was bronchopneumonia, present in 24 of 46 patients (52%): in 10 of 24 (42%) patients with HAART and 14 of 22 (64%) without. Cavitation was seen in 1 of 24 (4%) patients with HAART and in 5 of 22 (23%) without HAART.


CONCLUSIONS
Cavitation was more frequent in patients that were not receiving HAART, and normal chest radiographs were more frequently seen in patients on HAART.
Busi Rizzi
E
E
Diagnostic Department-Radiology, Clinical Pathology and Microbiology Laboratory, and Clinical Department, National Institute for Infectious Diseases L Spallanzani, Rome, Italy. radiologia@inmi.it
Schininà
V
V
Bordi
E
E
Buontempo
G
G
Narciso
P
P
Bibbolino
C
C
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies