[Bacterial pneumonia in HIV-infected patients (excluding mycobacterial infection)]

Rev Mal Respir. 2012 Oct;29(8):1058-66. doi: 10.1016/j.rmr.2012.06.003. Epub 2012 Jul 20.
[Article in French]

Abstract

Respiratory infections are the most common complications in HIV patients, regardless of the degree of immunosuppression. Even though antiretroviral therapy has a protective effect on the risk of bacterial pneumonia, this still remains high (including those with CD(4)>500/mm(3)). The most frequently isolated bacteria are Streptococcus pneumoniae and Haemophilus influenzae. The clinical and radiological presentations of lower respiratory tract infections in HIV patients are quite variable. The clinical presentation is more severe and the radiological presentation is more atypical if the immunosuppression is severe. The first-line antibiotic therapy is an injectable third-generation cephalosporin (ceftriaxone or cefotaxime) or co-amoxiclav. Pneumococcal vaccination (as well as influenza vaccine) is recommended. Although rare, Nocardia spp. and Rhodococcus equi seem more common among AIDS patients.

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / microbiology
  • AIDS-Related Opportunistic Infections / prevention & control
  • Actinomycetales Infections / diagnosis
  • Actinomycetales Infections / drug therapy
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods
  • Cephalosporins / therapeutic use
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Evidence-Based Medicine
  • France / epidemiology
  • HIV Infections / complications
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Immunocompromised Host*
  • Influenza Vaccines / administration & dosage
  • Nocardia Infections / diagnosis
  • Nocardia Infections / drug therapy
  • Pneumococcal Vaccines / administration & dosage
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / prevention & control
  • Rhodococcus equi / isolation & purification
  • Severity of Illness Index
  • Streptococcus pneumoniae / isolation & purification
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Influenza Vaccines
  • Pneumococcal Vaccines
  • Amoxicillin-Potassium Clavulanate Combination