CHLAMYDIA-PNEUMONIAE RESPIRATORY-INFECTIONS AMONG PATIENTS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

Thirteen cases of Chlamydia pneumoniae infection in patients seroposit ive for the human immunodeficiency virus (HIV) are described, The occu rrence, the clinical spectrum, and the significance of the infection d uring HIV disease are compared with data reported in the literature. C hlamydia pneumoniae infection was established by a serologic micro-imm unofluorescence test using standard diagnostic criteria, In four cases the results of serological tests were confirmed by direct immunofluor escence on respiratory specimens. Five patients developed focal pneumo nia but recovered completely after specific antibiotic treatment, Thre e patients developed severe and diffuse interstitial pulmonary involve ment, two of whom died of acute respiratory failure, Five patients dev eloped upper respiratory tract infection. Using 39 pair-matched HIV-se ropositive subjects as controls, the cases of infection were found to be significantly associated with a previously diagnosed pulmonary dise ase, Upon retrospective analysis of 319 consecutive cases of pneumonia among HIV-infected patients, Chlamydia pneumoniae was the sole agent detected in eight (2.5%) cases, and Chlamydia pneumoniae together with other infectious agents was detected in seven (2.2%) cases. Chlamydia pneumoniae is a possible cause of severe respiratory infection in Ita lian HIV-infected immunocompromised patients, and its presence must be suspected when patients do not respond to therapy with beta-lactam ag ents or to anti-Pneumocystis carinii treatment.