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35 - HIV-Associated Respiratory Infections

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

Matthew Fei
Affiliation:
Pulmonary/Critical Care Fellow, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA
Laurence Huang
Affiliation:
Professor of Medicine, University of California, San Francisco School of Medicine, Chief, AIDS Chest Clinic, Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division, San Francisco General Hospital, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

Shortness of breath is a common presenting complaint in human immunodeficiency virus (HIV)–infected patients, and the relevant differential diagnosis is broad. Etiologies include both infectious and noninfectious causes related and unrelated to underlying HIV infection and range from the minor (e.g., viral upper respiratory infection) to the life-threatening (e.g., Pneumocystis pneumonia [PCP]). Although the list of potential diseases may seem overwhelming, an understanding of the most commonly encountered pulmonary complications and their characteristic presentations will help narrow the differential diagnosis.

EPIDEMIOLOGY

The rate of bacterial pneumonia is between 5- and 25-fold higher in HIV-infected patients than in the non-HIV infected population. Although its prevalence has declined after the introduction of highly active anti-retroviral therapy (HAART), PCP is still a common acquired immunodeficiency syndrome (AIDS)-defining illness and is seen almost exclusively in immunocompromised persons. Globally, Mycobacterium tuberculosis (TB) pneumonia is the major pulmonary infection complicating the HIV epidemic. HIV-infected patients who have latent TB infection face a 10% annual risk of progressing from latent to active tuberculous disease compared to an approximately 10% lifetime risk in non-HIV-infected individuals. (See Chapter 33, Tuberculosis.)

CLINICAL FEATURES

The clinical presentations of common HIV-associated pulmonary infections often overlap. The goal of a thorough history and physical is to narrow the differential diagnosis, recognize constellations of particular symptoms and signs, and guide diagnostic testing and therapy.

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Publisher: Cambridge University Press
Print publication year: 2008

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References

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  • HIV-Associated Respiratory Infections
    • By Matthew Fei, Pulmonary/Critical Care Fellow, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA, Laurence Huang, Professor of Medicine, University of California, San Francisco School of Medicine, Chief, AIDS Chest Clinic, Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.036
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • HIV-Associated Respiratory Infections
    • By Matthew Fei, Pulmonary/Critical Care Fellow, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA, Laurence Huang, Professor of Medicine, University of California, San Francisco School of Medicine, Chief, AIDS Chest Clinic, Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.036
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • HIV-Associated Respiratory Infections
    • By Matthew Fei, Pulmonary/Critical Care Fellow, University of California, San Francisco School of Medicine, San Francisco General Hospital, San Francisco, CA, Laurence Huang, Professor of Medicine, University of California, San Francisco School of Medicine, Chief, AIDS Chest Clinic, Division of Pulmonary and Critical Care Medicine and HIV/AIDS Division, San Francisco General Hospital, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.036
Available formats
×