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Opportunistic infections in patients with pulmonary alveolar proteinosis

Ankit D Punatar1, Shimon Kusne, Janis E Blair

  • 1Department of Internal Medicine, Mayo Clinic, Phoenix, AZ, USA.

The Journal of Infection
|April 10, 2012
PubMed
Abstract

Insights

Pulmonary alveolar proteinosis (PAP) patients frequently develop opportunistic infections like nocardial, mycobacterial, or fungal pathogens, which can appear before or after PAP diagnosis. Early consideration of PAP is vital for patients with unexplained infections and lung infiltrates.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Critical Care

Background:

  • Pulmonary alveolar proteinosis (PAP) is a rare lung disorder.
  • Opportunistic infections pose a significant threat to PAP patients.

Observation:

  • A literature review identified 75 cases of PAP with opportunistic infections (Nocardia, mycobacteria, fungi).
  • Infections occurred before, after, or concurrently with PAP diagnosis.
  • Extra-pulmonary involvement was noted in 32% of cases.

Findings:

  • Nocardial infections were most common (43%), followed by mycobacterial (37%) and fungal (20%).
  • Over half of the patients (57%) survived, but 31 patients died.
  • Immunosuppression and smoking were noted risk factors.

Implications:

  • PAP should be considered in immunocompetent individuals presenting with opportunistic infections and diffuse alveolar infiltrates.
  • The timing of opportunistic infections relative to PAP diagnosis is variable.
  • Understanding these associations can improve diagnostic and treatment strategies for PAP patients.

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