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- Pneumococcal Bacteremia with Pneumonia (2)

AIDS was diagnosed according to the Centers for Disease Control surveillance definition. For each of the 50 episodes of bacterial pneumonia, we recorded demographic data, clinical and roentgenographic presentation, lactate dehydrogenase (LDH) levels, peripheral leukocyte count, antibiotic therapy, and outcome.
Serotyping for strep pneumonia is not routinely done at this hospital and was not done in this study.
Statistical Analysis
One-way analysis of variance (ANOVA) was used to compare differences in laboratory data between groups. The x* and two-sample Z test for independent proportions were used to evaluate differences in outcome. The x2 was also used to evaluate differences in clinical presentation and roentgenographic abnormalities between groups. Results were considered significant if p<0.05.
Results
The three distinct groups in this study are AIDS patients (group 1), non-HIV-infected (control) subjects (group 2), and HIV-infected non-AIDS patients (group 3). Tables 1, 2, and 3 describe patient groups 1, 2, and 3, respectively. Table 4 compares additional demographic and clinical data among all three groups.

Table 1 — Patients with AIDS (Group 1)

PatientNo./Age,yrt/Sex Basis for AIDS Diagnosis ChronicCondition Outcome^
Risk Infection
1/33/M H PCP§ Splenectomy Died
2/60/M unk PCP COPD Died
3/53/M H PCP Improved
4/32/M IVDA PCP Died
5/35/M H PCP Splenectomy Died
6/42/M H PCP Improved
7/35/M IVDA Candida Died
8/35/M H PCP CRF Improved
9/25/F IVDA PCP Died
10/34/M IVDA PCP Improved
10/40/M IVDA PCP Improved
12/36/F IVDA TOXO Improved
13/30/M IVDA PCP Died
14/50/M unk TOXO Died

Table 2—Non-HIV-lnfected Control Patients (Group 2)

PatientNo./Age,yrf/Sex Risk ChronicDisease Outcome^
1/34/M Etoh liver disease Died
2/59/M Etoh liver disease Died
3/3Q/F IVDA Improved
4/27/F Improved
5/24/M Improved
6/21/M H Improved
7/42/M IVDA Improved
8/65/M Improved
9/47/F IVDA Improved
10/47/F Died
11/46/F Improved
12/59/M Died
13/31/M Improved
14/34/M Improved
15/55/M Etoh cirrhosis Died
16/34/M Improved
17/30/F Improved
18/32/M Improved
19/84/F Improved
20/59/F Improved
21/24/M Improved
22/35/M IVDA Died
23/33/M Improved
24/34/M IVDA Improved

Table 3—HIV-injected Non-AIDS Patients (Group 3)

PatientNo./Age,yrf/Sex Risk ChronicDisease Outcome
1/43/M H Improved
2/35/M H Improved
3/39/Mt IVDA CAH, cirrhosis Improved
4/28/M IVDA Improved
5/42/M IVDA Improved
6/44/M H Improved
7/40/M $ IVDA CAH, cirrhosis Improved
8/37/F IVDA Asthma Improved
9/27/M H Asthma Improved
10/47/M H Improved
11/43/F IVDA Improved
12/38/M unk Improved

Table 4—Demographics, Clinical Characteristics, and Outcome in Group 1 (AIDS), Group 2 (Control), and Group 3 (HIV-Infected Non-AIDS) Patients

Group 1 Croup 2 Croup 3
Demographics
White 3 10 7
Black 8 12 2
Hispanic 3 2 3
Clinical presentation
Fever 11 (79%) 16 (67%) 8 (67%)*
Productive cough 9 (64%) 17 (71%) 7 (58%)*
Chest pain 2 (14%) 9 (38%) 2 (17%)*
Dyspnea 6 (43%) 8 (33%) 6 (50%)*
Laboratory data
WBC, x 10*/L 13,886 ± 12,581 12,363 ±6,196 9,092 ± 10,138t
Range 800-39,400 2,000-26,500 900-37,100
LDH, IU/L 371 ±159 216 ±75 268±129t
Range 197-638 125-353 112-511
Radiologic data
Unilateral infiltrate 6 (42.9%) 20 (83.3%) 10 (83.3%)$
Left-sided 2 7 8
Right-sided 4 13 2
Bilateral infiltrates 8 (57.1) 4 (16.7%) 2 (16.7%)$
Pleural effusion 2 2 0
Treatment
Penicillin antibiotics 6 15 7
Erythromycin 0 1 2
Cephalosporin 4 6 3
Trimethoprim-sulfamethoxazole 4 0 0
Clindamycin 0 1 0
None 0 1 0
Clinical outcome
Improved 6 (42.9%) 18 (75%) 12 (100%)
Died 8 (57.1%) 6 (25%)§ 01
June 27, 2013 Pulmonary function
Tags: aids patients antibiotic therapy hiv infection penicillin pneumonia septic shock