UnissResearch

Logo Universitàegli studi di Sassari
titoli, abstracts, parole chiave >>>
Bacterial community-acquired pneumonia in HIV-infected patients

Madeddu, Giordano and Fiori, Maria Laura and Mura, Maria Stella Anna (2010) Bacterial community-acquired pneumonia in HIV-infected patients. Current Opinion in Pulmonary Medicine, Vol. 16 (3), p. 201-207. ISSN 1070-5287. Article.

Full text not available from this repository.

DOI: 10.1097/MCP.0b013e3283375825

Abstract

Purpose of review: In this review, we focus on the clinical features, diagnosis, outcome and management of bacterial community-acquired pneumonia (BCAP) in HIV-infected patients, with particular attention to the most recent findings in this area.
Recent findings: Clinical features of BCAP are often atypical in HIV-infected individuals, especially when liver cirrhosis is also present. Streptococcus pneumoniae is the most common causative agent and is frequently associated with bacteriemic disease even in low-risk patients according to pneumonia severity index. An etiologic diagnosis is obtained in an average 35% of cases with standard culture methods. In such conditions, urinary antigen test for S. pneumoniae identification may help in reaching a rapid and etiologic diagnosis. CD4 cell count should be carefully considered in HIV patients with BCAP. In consideration of their high mortality risk, patients with a CD4 cell count of less than 200 cells/µl should be hospitalized, whereas those with a CD4 cell count of at least 200 cells/µl could be managed according to pneumonia severity index score. Empiric antibiotic therapy should include a combination of a [beta]-lactam and a macrolide or a respiratory fluoroquinolone alone. Finally, prevention strategies should include lifestyle modification, highly active antiretroviral therapy access and adherence programs and the implementation of pneumococcal vaccination.
Summary: A correct diagnosis and management together with a comprehensive approach to preventive measures, including lifestyle modification, highly active antiretroviral therapy access and adherence programs and the implementation of pneumococcal vaccination, are key factors to reduce BCAP incidence and mortality in HIV-infected patients.

Item Type:Article
ID Code:4289
Status:Published
Refereed:Yes
Uncontrolled Keywords:Bacterial community-acquired pneumonia, diagnosis, HIV, management, prevention, risk factors
Subjects:Area 06 - Scienze mediche > MED/17 Malattie infettive
Area 06 - Scienze mediche > MED/10 Malattie dell'apparato respiratorio
Divisions:001 Università di Sassari > 03 Istituti > Malattie infettive e parassitarie
Publisher:Lippincott Williams & Wilkins
ISSN:1070-5287
Deposited On:28 Jul 2010 11:12

I documenti depositati in UnissResearch sono protetti dalle leggi che regolano il diritto d'autore

Repository Staff Only: item control page