The occurrence of sinusitis in HIV-infected patients with fever

Sinusitis is commonly occurring in patients infected with Human Immunodefic iency Virus I (HIT), but the occurrence and etiology have not been establis hed. The purpose of this study was prospectively to determine the occurrenc e, site and type of paranasal sinus abnormalities seen on MRI in HIV-infect ed patients with fever, to relate the abnormalities to clinical and immunol ogical parameters, and to determine the microbiological agents found in the sinus aspirates. MRI was performed in 54 HIV-infected patients with 70 eva luable episodes of fever. Patients receiving antibiotics were excluded. Bac trim was permitted, when given as prophylaxis of Pneumocystis carinii pneum onia. If abnormalities were found on MRI, sinus aspiration was performed an d the aspirate investigated. MRI abnormalities were found in 54.3% of the p atients with a significantly higher occurrence of pathological changes in A IDS patients compared with HIV-infected without AIDS. In approximately 2/3 of the aspirates a probable, etiologic agent was found. However, 1/3 of the se agents were atypical such as cytomegalovirus and mycobacteriae; in one p atient Non-Hodgkin's lymphoma was found. The high occurrence of sinusitis in HIV-infected patients and the atypical findings in the sinus aspirates stress the importance of searching for sinu sitis and the etiology to ensure the correct treatment.