PSEUDOMONAS-AERUGINOSA BRONCHOPULMONARY INFECTION IN PATIENTS WITH ADVANCED HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE

Pseudomonas aeruginosa is increasingly reported as a respiratory patho gen in patients with advanced human immunodeficiency virus (HIV) disea se. We retrospectively reviewed the chest radiographic appearances of 29 HIV-infected adults with bronchopulmonary infection in whom Pseudom onas aeruginosa was the sole respiratory pathogen isolated. The common est radiographic abnormality was a diffuse reticular (11 patients) or reticulonodular (9 patients) infiltrate in the pulmonary interstitium. Alveolar opacification was seen in seven patients. Cavitation was rar e (2 patients), as was ground-glass opacification (2 patients). Five p atients had pleural effusions. No patient had mediastinal or hilar lym phadenopathy. Normal chest radiographs were seen in eight patients. Al though the radiographic appearances of Pseudomonas bronchopulmonary in fection in HIV-infected patients are non-specific, an interstitial inf iltrate is a common finding. Pseudomonas aeruginosa should be consider ed along with the commoner pathogen Pneumocystis carinii in the differ ential diagnosis of an interstitial infiltrate in this group of patien ts.