Pulmonary infections in HIV infected patients

We retrospectively reviewed causes, clinical presentations and chest radiographs of pulmonary infections in symptomatic HIV infected patients diagnosed in Srinagarind Hospital from February 1992 to 1994. We found 95 episodes of pulmonary infections in 88 HIV infected patients enrolled in our review. The three most common pathogens were Mycobacterium tuberculosis (37.2%), Pneumocystis carinii (23.8%), and Cryptococcus (15.2%). Coexistent pulmonary infections were seen in 10.5 per cent, mostly due to P. carinii and Cryptococcus neoformans. Extrapulmonary infections were also common, particularly with M. tuberculosis (49%) and C. neoformans (100%). The common clinical presentations were fever, dyspnea, and cough which frequency varied among the organisms. Chest radiographs were nonspecific, the most common finding was bilateral pulmonary infiltrates except that bacterial pneumonia usually presented with unilateral infiltrates. All patients wit PC had significant hypoxia (PaO2 < 70 mmHg). Due to nonspecific clinical and chest film presentations as well as frequent coinfections, definite diagnosis should be carried out in all HIV infected patients with pulmonary infections.