Journal Article

Dual Pulmonary Infection with <i>Mycobacterium tuberculosis</i> and <i>Pneumocystis carinii</i> in Patients Infected with Human Immunodeficiency Virus

Dragana Orlovic, Ranmini Kularatne, Vivian Ferraz and Raymond A. Smego

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 2, pages 289-294
Published in print January 2001 | ISSN: 1058-4838
Published online January 2001 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/318475
Dual Pulmonary Infection with Mycobacterium tuberculosis and Pneumocystis carinii in Patients Infected with Human Immunodeficiency Virus

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During a 22-month period, we identified 39 patients with human immunodeficiency virus (HIV) infection (mean CD4+ count, 90 cells/mm3) who were hospitalized with pneumonia and who had sputum and/or other specimens that tested concurrently positive for both Mycobacterium tuberculosis and Pneumocystis carinii. The most common chest x-ray abnormality was a reticulonodular pattern or bilateral infiltrates (n = 26). Serum lactate dehydrogenase levels were elevated in 17 (85%) of 20 of patients tested (mean value, 2208 U/L). Mean O2 saturation and PO2 were 89% and 64 mm Hg, respectively. A majority (24 patients [62%]) received both antituberculous and anti-PCP therapy (17 with steroids), and 22 improved. All ten patients who received no treatment for PCP improved and were discharged from the hospital, whereas 4 (80%) of the 5 persons who received no antituberculous treatment had a poor outcome (P < .001; OR = 43). Patients with HIV or acquired immune deficiency syndrome may present with both TB and PCP; of the 2, TB seems to account for the most severe features of disease.

Journal Article.  3055 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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