A Case of AIDS-associated Haemophilus influenzae Pneumonia with Diffuse Reticulonodular Shadows
Mitsuru Konishi1) Takahito Nakamura2) Eiichiro Yoshimoto1) Ken Takahashi1) Kei Mori3) Koichi Maeda4) Kaoru Hamada1) Keiichi Mikasa1) Nobuhiro Narita5)
1)Second Department of Internal Medicine, Nara Medical University
2)Internal Medicine, Saiseikai-Chuwa Hospital
3)Internal Medicine, Akitsu-Kohnoike Hospital
4)General Medicine and Clinical Investigation, Nara Medical University
5)Nara-Kohseikai Hospital
A 32-year-old male was admitted to our hospital complaining of fever and dyspnea on effort. Laboratory data on admission indicated leukocytosis and elevation of C-reactive protein. A chest radiograph showed diffuse reticulonodular shadows in both lower lung fields, and a chest computed tomography showed centrilobular reticulonodular opacity. Bronchoscopic findings revealed a large amount of slightly yellowish secretion in all bronchi. Cells found in the bronchoalveolar lavage fluid (BALF) included 61% neutrophils. Haemophilus influenzae was isolated from cultures of the BALF and sputum. Transtracheal lung biopsy specimens showed focal infiltration of neutrophils in the alveoli, and the pathological findings in the lung were compatible with bronchiolopneumonia. Since the CD4/CD8 ratio was 0.09 and a positive reaction was obtained for anti-human immunodeficiency virus (HIV) antibody, HIV-associated pneumonia due to H. influenzae was diagnosed. Seven days'administration of cefozopran improved the patient's condition. It is interesting that radiological findings are often unusual in HIV-infected patients with H. influenzae pneumonia.
Haemophilus influenzae Pneumonia AIDS
Received 平成14年1月7日
JJRS, 40(11): 905-909, 2002