Related Experiment Videos
Chlamydia pneumoniae respiratory infections among patients infected with the human immunodeficiency virus
U V Comandini1, P Maggi, P Santopadre
1Department of Infectious and Tropical Diseases, University La Sapienza of Rome, Italy.
Abstract:
Thirteen cases of Chlamydia pneumoniae infection in patients seropositive for the human immunodeficiency virus (HIV) are described. The occurrence, the clinical spectrum, and the significance of the infection during HIV disease are compared with data reported in the literature. Chlamydia pneumoniae infection was established by a serologic micro-immunofluorescence test using standard diagnostic criteria. In four cases the results of serological tests were confirmed by direct immunofluorescence on respiratory specimens. Five patients developed focal pneumonia but recovered completely after specific antibiotic treatment. Three patients developed severe and diffuse interstitial pulmonary involvement, two of whom died of acute respiratory failure. Five patients developed upper respiratory tract infection. Using 39 pair-matched HIV-seropositive subjects as controls, the cases of infection were found to be significantly associated with a previously diagnosed pulmonary disease. Upon retrospective analysis of 319 consecutive cases of pneumonia among HIV-infected patients, Chlamydia pneumoniae was the sole agent detected in eight (2.5%) cases, and Chlamydia pneumoniae together with other infectious agents was detected in seven (2.2%) cases. Chlamydia pneumoniae is a possible cause of severe respiratory infection in Italian HIV-infected immunocompromised patients, and its presence must be suspected when patients do not respond to therapy with beta-lactam agents or to anti-Pneumocystis carinii treatment.
Insights
Chlamydia pneumoniae infections can cause severe respiratory illness in human immunodeficiency virus (HIV)-positive patients. Suspect this pathogen in HIV patients with pneumonia unresponsive to standard antibiotic treatments.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunocompromised Host
Background:
- Human immunodeficiency virus (HIV) infection compromises the immune system, increasing susceptibility to opportunistic infections.
- Chlamydia pneumoniae is an emerging pathogen that can cause respiratory illness in various populations.
Purpose of the Study:
- To describe the clinical characteristics and significance of Chlamydia pneumoniae infection in HIV-seropositive patients.
- To compare the occurrence and spectrum of Chlamydia pneumoniae infection in HIV-infected patients with existing literature.
Main Methods:
- Retrospective analysis of 13 HIV-seropositive patients with Chlamydia pneumoniae infection.
- Serological micro-immunofluorescence and direct immunofluorescence tests were used for diagnosis.
- Comparison with 39 pair-matched HIV-seropositive controls and analysis of 319 pneumonia cases in HIV patients.
Main Results:
- Chlamydia pneumoniae infection was associated with prior pulmonary disease in HIV patients.
- Five patients developed focal pneumonia, three had severe interstitial pneumonia (two fatal), and five had upper respiratory tract infections.
- Chlamydia pneumoniae was identified as the sole agent in 2.5% and a co-infecting agent in 2.2% of HIV-associated pneumonia cases.
Conclusions:
- Chlamydia pneumoniae can cause severe respiratory infections, including fatal pneumonia, in Italian HIV-infected immunocompromised patients.
- The presence of Chlamydia pneumoniae should be suspected in HIV patients with pneumonia unresponsive to beta-lactam or anti-Pneumocystis carinii therapies.