• DOI:10.1378/CHEST.112.5.1197
• Corpus ID: 41571062

Salmonella lung involvement in patients with HIV infection.

@article{Casado1997SalmonellaLI,
  title={Salmonella lung involvement in patients with HIV infection.},
  author={Jos{\'e} Lu{\'i}s Casado and Enrique Navas and Bego{\~n}a Frutos and Alberto Moreno and P. Mart{\'i}n and Jos{\'e} Manuel Hermida and Antonio Guerrero},
  journal={Chest},
  year={1997},
  volume={112 5},
  pages={
          1197-201
        }
}

• J. Casado, E. Navas, +4 authors A. Guerrero
• Published 1 November 1997
• Medicine, Biology
• Chest

STUDY OBJECTIVE
To determine the frequency, clinical features, and outcome of lung involvement in HIV-infected patients having nontyphoid strains of Salmonella bacteremia.

DESIGN
A retrospective clinical study.

PATIENTS AND SETTING
We studied the records of all HIV-infected patients with Salmonella bacteremia diagnosed at a university tertiary hospital from January 1987 to December 1995.

RESULTS
Lung involvement was found in 18 (35.3%) of 51 HIV-infected individuals with Salmonella bacteremia. Six of 18 (33.3%) were diagnosed as having definite Salmonella pulmonary infection by isolation of Salmonella from respiratory specimens, while probable Salmonella lung disease was considered in two patients who developed lung abscesses without the identification of any pathogen. Predisposing factors for focal disease, such as prior lung disease or Salmonella serotype, were equally prevalent regardless of the presence of Salmonella pulmonary involvement. Cavitary infiltrates or abscess formation were seen in five of the eight patients. With the exception of one patient coinfected with Nocardia asteroides who died 1 month later, all patients were cured with antibiotic treatment. Superinfection with other pulmonary pathogens (10 cases, 56%) was more frequent than Salmonella pneumonia; the most frequent alternative diagnosis was Pneumocystis carinii pneumonia (5 cases, 28%), pyogenic bacterial infection (17%), and tuberculosis (11%).

CONCLUSIONS
In HIV-infected patients with Salmonella bacteremia, lung involvement is frequent, although there were no significant factors to explain this association. Cavitary disease was the most common radiologic pattern, and focal lung disease due to Salmonella does not seem to be associated with a worse prognosis. Coinfection and superinfection with other respiratory pathogens are more common than isolated Salmonella lung disease, and therefore, additional diagnostic procedures must be considered in the evaluation of these patients.