AEGiS-14IAC: Sinusitis and AIDS.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Sinusitis and AIDS.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no.. A10025)

Farenzena PR
Universidade Federal do Rio de Janeiro, Porto Alegre, Brazil

INTRODUCTION: This study had the following objectives: a- Identify prevalent pathogens in symptomatic maxillary sinusitis in patients with AIDS. b- Determine the susceptibility of microorganisms to the various antimicrobial agents. c- Provide a study to guide the therapy of sinusitis in patients with AIDS.

METHODS: The maxillary sinuses of 23 patients were punctured through the nasal cavity in the superior meatus, and 36 samples were collected for microbiological analysis.

RESULTS: CD4+ T lymphocyte count (information available for 18 of the 23 patients): - Below 250 cel/mm³ - 10/10 (55.5%) - Between 250 and 500 cel/mm³ - 5/18 (27%) - Above 500 cel/mm³ - 3/18 (16.6%).

BACTERIOLOGY RESULTS: Findings were negative (absence of Gram bacteria and absence of bacterial growth in culture) for 16 (69.5%) of the 23 cases and 25 (65.4%) clinical specimens collected. Of the 7 bacteriology positive cases, 42% were caused by Staphylococcus epidermidis. Other bacteria found: coagulase-negative Staphylococcus, S.aureus, Streptococcus spp, and one case of infection by anaerobes: Peptococcus spp, Veillonela spp, Eubacterium spp. In the case of Gram-positive cocci, Gram was correlated with culture. Of the bacteria found, 42% were resistant to penicillin. One case (S.aureus) was sensitive only to vancomycin. Investigation of acid alcohol bacilli was negative in 100% of the cases; investigation of Legionella pneumophila, Pneumocistis carinii and fungi was also negative.

CONCLUSION: Antibiotic therapy is very likely to be innocuous, as well as expensive for both patients and the health system. If empiric treatment fails, an etiologic diagnosis should be made by puncture of the maxillary sinuses.

020707
A10025