AIDS AND THE LUNG

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PNEUMOCYSTIS CARINII PNEUMONIA

Chagas17 originally described P. carinii as a trypanosome in the lungs in 1909. The Delanoes reclassified P. carinii as a separate species of protozoan in 1912, and it was first recognized as a human pathogen in 1957. PCP remained an uncommon infection until 1981, when its occurrence in homosexual men and injection drug users heralded the beginning of the AIDS epidemic.37,59 Today, PCP remains the most common AIDS-defining opportunistic infection in the United States, but its relative frequency

BACTERIAL PNEUMONIA

Bacterial infections are common in HIV-infected persons. HIV-infected persons are especially susceptible to infections by the encapsulated bacteria, Streptococcus pneumoniae and Haemophilus influenzae. Pneumonia caused by Pseudornonas aeruginosa appears to be increasing in frequency.

OBSTRUCTIVE LUNG DISEASES AND HUMAN IMMUNODEFICIENCY VIRUS

The initial focus in the evaluation of respiratory symptoms in an HIV-infected person is placed on prompt diagnosis of a possible pulmonary infection. HIV-infected persons, however, are also susceptible to a wide variety of noninfectious pulmonary conditions. Respiratory symptoms often are secondary to one of the obstructive lung diseases. This section reviews the current understanding of the obstructive lung diseases and HIV infection.

SUMMARY

Respiratory symptoms are common in HIV-infected persons. The challenge facing clinicians is to determine whether these respiratory symptoms are due to an opportunistic infection or to a chronic process, such as asthma, chronic bronchitis, bronchiectasis, or emphysema. This article reviewed the clinical presentation, diagnosis, and treatment of two important opportunistic infections, PCP and bacterial pneumonia. It also reviewed the current data on obstructive lung diseases as they relate to HIV.

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