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Pneumococcal pneumonia: clinical features, diagnosis and management in HIV-infected and HIV noninfected patients

Madeddu, Giordano and Fois, Alessandro Giuseppe and Pirina, Pietro and Mura, Maria Stella Anna (2009) Pneumococcal pneumonia: clinical features, diagnosis and management in HIV-infected and HIV noninfected patients. Current Opinion in Pulmonary Medicine, Vol. 15 (3), p. 236-242. ISSN 1070-5287. Article.

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DOI: 10.1097/MCP.0b013e32832a09e0

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Abstract

Purpose of review:
In this review, we focus on the clinical features, diagnosis and management of pneumococcal pneumonia in HIV-infected and noninfected patients, with particular attention to the most recent advances in this area.
Recent findings:
Classical clinical features are found in young adults, whereas atypical forms occur in immunocompromised patients including HIV-infected individuals. Bacteremic pneumococcal pneumonia is more frequently observed in HIV-infected and also in low-risk patients, according to the Pneumonia Severity Index (PSI). Pneumococcal pneumonia diagnostic process includes physical examination, radiologic findings and microbiologic diagnosis. However, etiologic diagnosis using traditional culture methods is difficult to obtain. In this setting, urinary antigen test, which recognizes Streptococcus pneumoniae cell wall C-polysaccharide, increases the probability of etiologic diagnosis. A correct management approach is crucial in reducing pneumococcal pneumonia mortality. The use of the PSI helps clinicians in deciding between inpatient and outpatient management in immunocompetent individuals, according to Infectious Diseases Society of America (IDSA)–American Thoracic Society (ATS) guidelines. Recent findings support PSI utility also in HIV-infected patients. Recently, efficacy of pneumococcal vaccine in reducing pneumococcal disease incidence has been evidenced in both HIV-infected and noninfected individuals.
Summary:
Rapid diagnosis and correct management together with implementation of preventive measures are crucial in order to reduce pneumococcal pneumonia related incidence and mortality in HIV-infected and noninfected patients.

Item Type:Article
ID Code:6429
Status:Published
Refereed:Yes
Uncontrolled Keywords:Clinical features, diagnosis, HIV, management, pneumococcal pneumonia
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
Copyright Holders:© 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Deposited On:30 Aug 2011 17:37

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