Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Heart Lung. 2012 Jan-Feb;41(1):76-82. doi: 10.1016/j.hrtlng.2011.05.004. Epub 2011 Oct 17.
Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infections in young children, the elderly, and immunocompromised hosts, but RSV is a rare cause of community-acquired pneumonia (CAP) in hospitalized adults with human immunodeficiency virus (HIV). In patients with HIV, CAP is most frequently attributable to the usual bacterial respiratory pathogens that cause CAP in immunocompetent hosts, eg, Streptococcuspneumoniae or Hemophilus influenzae. Adults with HIV are also predisposed to intracellular CAP pathogens, ie, Mycoplasmatuberculosis, Salmonella spp., Pneumocystis (carinii) jiroveci (PCP), cytomegalovirus, and Legionella spp. This year, co-circulating in the community during influenza season were strains of human seasonal influenza A (H3N2) and swine influenza A (H1N1). During the influenza season, in adults hospitalized with HIV, the diagnostic possibilities should include influenza-like illnesses, eg, human parainfluenza virus types 3 and 4, human metapneumovirus, and pertussis.
We present an adult with HIV, hospitalized for an influenza-like illness during influenza season. The differential diagnosis of CAP in this patient included influenza A and PCP.
We report on an adult patient with HIV with CAP that mimicked influenza and PCP, and was attributable to RSV.
呼吸道合胞病毒（RSV）是导致婴幼儿、老年人和免疫功能低下宿主下呼吸道感染的重要原因，但 RSV 很少导致人类免疫缺陷病毒（HIV）感染住院成人的社区获得性肺炎（CAP）。在 HIV 患者中，CAP 最常归因于引起免疫功能正常宿主 CAP 的常见细菌性呼吸道病原体，例如肺炎链球菌或流感嗜血杆菌。HIV 成人也易患细胞内 CAP 病原体，例如结核分枝杆菌、沙门氏菌、卡氏肺孢子虫（PCP）、巨细胞病毒和军团菌。今年，流感季节社区中同时流行季节性甲型流感（H3N2）和猪流感（H1N1）。在流感季节，HIV 感染住院成人中，应包括流感样疾病在内的诊断可能性，例如人类副流感病毒 3 型和 4 型、人偏肺病毒和百日咳。
我们介绍了一名 HIV 感染成人，在流感季节因流感样疾病住院。该患者 CAP 的鉴别诊断包括甲型流感和 PCP。
我们报告了一名 HIV 成人患者的 CAP，该患者的 CAP 类似于流感和 PCP，病因是 RSV。
