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Parapneumonic effusions secondary to community-acquired bacterial pneumonia in human immunodeficiency virus-infected
V Gil Suay1, P J Cordero, E Martínez
1Hospital Universitari La Fe, Servicio de Neumología, Valencia, Spain.
Abstract:
The purpose of this study was to determine whether the clinical and microbiological characteristics of parapneumonic effusions in patients with community-acquired pneumonia (CAP) infected with the human immunodeficiency virus (HIV) were different from those observed in patients without HIV infection. One hundred and thirty seven patients with parapneumonic effusions were included and divided into two groups depending on whether they had HIV infection or not. The parapneumonic effusion rate was significantly higher in HIV-positive than in noninfected patients (21 vs 13%). Their clinical course was more severe, presenting a higher rate of bacteraemias (58 vs 18%). Pleural fluid in patients infected with HIV had significantly lower glucose levels than that of patients without HIV infection. Chest tube drainage was more frequent in parapneumonic effusions of patients infected with HIV than in those without HIV infection (71 vs 44%). Staphylococcus aureus was the most common microorganism found in the bacteriological samples of patients with CAP infected with HIV (53 vs 12%). We conclude that patients with community-acquired pneumonia and HIV infection have a higher rate of parapneumonic effusions and a more severe clinical course than non-HIV patients, and that Staphylococcus aureus predominates in their bacteriological samples.
Insights
Patients with community-acquired pneumonia (CAP) and human immunodeficiency virus (HIV) infection experience more severe parapneumonic effusions. Staphylococcus aureus is more common in HIV-positive patients with CAP and effusions.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- Community-acquired pneumonia (CAP) is a common infection.
- Human immunodeficiency virus (HIV) can alter infection susceptibility and severity.
- Parapneumonic effusions complicate pneumonia, requiring specific management.
Purpose of the Study:
- To compare clinical and microbiological features of parapneumonic effusions in CAP patients with and without HIV.
- To identify differences in effusion characteristics and outcomes based on HIV status.
Main Methods:
- Retrospective study of 137 patients with parapneumonic effusions.
- Patients divided into HIV-positive and HIV-negative groups.
- Analysis of clinical presentation, microbiological data, and treatment outcomes.
Main Results:
- Higher parapneumonic effusion rate in HIV-positive patients (21% vs 13%).
- More severe clinical course in HIV-positive patients, with higher rates of bacteremia (58% vs 18%) and lower pleural fluid glucose.
- Increased chest tube drainage (71% vs 44%) and predominance of Staphylococcus aureus (53% vs 12%) in HIV-positive patients.
Conclusions:
- HIV-infected patients with CAP have a higher incidence of parapneumonic effusions.
- These effusions are associated with a more severe clinical course and distinct microbiological profiles, notably Staphylococcus aureus.
- Findings highlight the need for tailored management strategies for CAP with parapneumonic effusions in HIV-positive individuals.