Unusual Manifestations of Pneumococcal Infection in Human Immunodeficiency Virus-Infected Individuals: The Past Revisited

Although AIDS was largely recognized and defined because of the increased presence of diseases that reflect deficiencies in cell-mediated immunity, susceptibility to common extracellular bacterial pathogens has also been shown to be increased. To our knowledge, adults with concurrent infection due t...

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Bibliographic Details
Published in:Clinical infectious diseases 1992-01, Vol.14 (1), p.192-199
Main Authors: Rodriguez Barradas, Maria C., Musher, Daniel M., Hamill, Richard J., Dowell, Mark, Bagwell, J. Todd, Sanders, Charles V.
Format: Article
Language:English
Subjects:
Abscesses
Adult
AIDS
AIDS/HIV
Antibodies
Bacteremia
Brain Abscess - complications
Cellulitis - complications
Clinical Infectious Disease Articles
Empyema, Pleural - complications
HIV
HIV infections
HIV Infections - complications
Humans
Infections
Internships
Male
Mediastinitis - complications
Middle Aged
Pleural Effusion - complications
Pneumococcal infections
Pneumococcal Infections - complications
Pneumococcal pneumonia
Pneumonia, Pneumococcal - complications
Pneumothorax - complications
Purpura - complications
Streptococcus pneumoniae
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Summary:Although AIDS was largely recognized and defined because of the increased presence of diseases that reflect deficiencies in cell-mediated immunity, susceptibility to common extracellular bacterial pathogens has also been shown to be increased. To our knowledge, adults with concurrent infection due to human immunodeficiency virus (HIV) and Streptococcus pneumoniae whose cases have been described to date have all had pneumococcal pneumonia and/or bacteremia. We describe five cases of HIV-infected patients who had unusual manifestations of pneumococcal infection, which include recurrent exudative pleural effusion, pyopneumothorax, purpura fulminans, mediastinitis with chest wall abscess, and multiple brain abscesses. Such complications of pneumococcal infection occurred more or less commonly in the preantibiotic era, but on the basis of our experience and an exhaustive literature search, these complications have been exceedingly rare in the past few decades. In four of our five patients, the unusual, complicated pneumococcal disease preceded and prompted a search for HIV infection. Because concurrent HIV infection increases the susceptibility to pneumococcal disease, other such cases are likely to be seen.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/14.1.192