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Diagnosing and treating cytomegalovirus pneumonia in patients with AIDS.


Clin Infect Dis. 1996 Jul;23(1):76-81. Unique Identifier : AIDSLINE

Because cytomegalovirus (CMV) can be isolated from pulmonary secretions of human immunodeficiency virus (HIV)-infected patients without causing disease, its clinical significance as a cause of pneumonia in this patient population is frequently questioned. In a 22-month period, CMV pneumonia was diagnosed in 17 (8%) of 210 HIV-infected patients who underwent lung biopsy on the basis of microbiological and histologic criteria. The clinical presentations of these patients were nonspecific, including fever (100% of patients), shortness of breath (71%), cough (76%), and Pao2 of < 75 mm Hg (88%). A high correlation in the degree of viral burden in lung biopsy specimens was demonstrated by histologic examination, immunohistochemical analysis, and in situ hybridization. No other pulmonary pathogens were identified for nine patients, whereas other possible causes of pneumonia were present in eight: 11 patients had evidence of extrapulmonary CMV disease at presentation. Most patients initially responded to specific anti-CMV therapy; the overall mean survival +/- SD was 3.1 +/- 2.5 months. CMV should be considered as a possible cause of pneumonia in patients with advanced AIDS especially if CMV infection is documented at other sites.

Adult Antiviral Agents/THERAPEUTIC USE AIDS-Related Opportunistic Infections/*DIAGNOSIS/*DRUG THERAPY Bronchoalveolar Lavage Fluid/VIROLOGY Bronchoscopy Cytomegalovirus/GENETICS/IMMUNOLOGY/ISOLATION & PURIF Cytomegalovirus Infections/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY Human Immunohistochemistry In Situ Hybridization Male Middle Age Pneumonia, Viral/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY JOURNAL ARTICLE


Information in this article was accurate in March 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.