title: Herpes Simplex Virus, Cytomegalovirus, and Pneumocystis jiroveci Pneumonia in a Treatment-Naive HIV-Positive Patient with Pulmonary Alveolar Proteinosis: Case Report.
abstract: Infection with multiple pathogens concurrently has become less common since the introduction of potent antiretroviral agent and effective prophylactic agents. We describe a patient with pulmonary alveolar proteinosis (PAP) admitted with pneumonia who was found to have AIDS and diagnosed with Pneumocystis jiroveci pneumonia, human herpesvirus type 1 (HHV-1), and a concomitant cytomegalovirus viremia. Polymerase chain reaction viral load was used for diagnosis of HHV-1 and follow-up. The patient was treated with trimethoprim-sulfamethoxazole and ganciclovir and had a resolution of pneumonia. Since patients with PAP who are diagnosed as having AIDS could be concomitantly infected with multiple pathogens, rapid accurate diagnosis and treatment may have a positive effect on outcome.
authors.affiliation: 1 Division of Infectious Disease, Newark Beth Israel Medical Center, Newark, NJ, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Bapat
authors.affiliation: 1 Division of Infectious Disease, Newark Beth Israel Medical Center, Newark, NJ, USA.
authors.forename: Eliahu
authors.initials: E
authors.lastname: Bishburg
authors.affiliation: 1 Division of Infectious Disease, Newark Beth Israel Medical Center, Newark, NJ, USA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Nagarakanti
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006679:HIV Seropositivity / Q000150:complications* / Q000188:drug therapy; D006561:Herpes Simplex / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000188:drug therapy; D011649:Pulmonary Alveolar Proteinosis / Q000150:complications*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015774:Ganciclovir
keywords: cytomegalovirus; herpes simplex virus; human immunodeficiency virus; pulmonary alveolar proteinosis