title: Respiratory syncytial virus (RSV) community-acquired pneumonia (CAP) in a hospitalized adult with human immunodeficiency virus (HIV) mimicking influenza A and Pneumocystis (carinii) jiroveci pneumonia (PCP).
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infections in young children, the elderly, and immunocompromised hosts, but RSV is a rare cause of community-acquired pneumonia (CAP) in hospitalized adults with human immunodeficiency virus (HIV). In patients with HIV, CAP is most frequently attributable to the usual bacterial respiratory pathogens that cause CAP in immunocompetent hosts, eg, Streptococcuspneumoniae or Hemophilus influenzae. Adults with HIV are also predisposed to intracellular CAP pathogens, ie, Mycoplasmatuberculosis, Salmonella spp., Pneumocystis (carinii) jiroveci (PCP), cytomegalovirus, and Legionella spp. This year, co-circulating in the community during influenza season were strains of human seasonal influenza A (H3N2) and swine influenza A (H1N1). During the influenza season, in adults hospitalized with HIV, the diagnostic possibilities should include influenza-like illnesses, eg, human parainfluenza virus types 3 and 4, human metapneumovirus, and pertussis.
  
  
  METHODS
  We present an adult with HIV, hospitalized for an influenza-like illness during influenza season. The differential diagnosis of CAP in this patient included influenza A and PCP.
  
  
  CONCLUSIONS
  We report on an adult patient with HIV with CAP that mimicked influenza and PCP, and was attributable to RSV.
authors: Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA. bacunha@Winthrop.org
authors: Burke A
authors: BA
authors: Cunha
authors: Uzma
authors: U
authors: Syed
authors: Jean E
authors: JE
authors: Hage
mesh_terms: D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis*; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000821:virology; D011859:Radiography; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis*; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*