Chirurgi V A, Edelstein H, McCabe R
Veterans Administration Medical Center, Martinez, CA 94553.
South Med J. 1990 Aug;83(8):895-9. doi: 10.1097/00007611-199008000-00012.
We retrospectively reviewed medical records of all adult patients with blood cultures positive for Streptococcus pneumoniae to determine the number of HIV seropositive patients in whom S pneumoniae bacteremia was the presenting manifestation. We also compared the clinical presentation, laboratory data, and outcome of pneumococcal bacteremia in patients who were HIV seropositive with patients with no risk factors for HIV infection. All adult patients with blood cultures positive for S pneumoniae from January 1987 through April 1989 at two acute care general hospitals in northern California were identified by review of microbiology data. One hospital served veterans, the other the indigent of a suburban area. Six (15%) of 41 patients with pneumococcal bacteremia were HIV seropositive; five were not known to be HIV seropositive before the onset of bacteremia, and the sixth was asymptomatic with respect to HIV infection. No patient with AIDS had pneumococcal bacteremia. HIV seropositive patients were significantly younger, had significantly fewer underlying diseases, and had fewer complications of pneumococcal bacteremia than bacteremic patients with no risk factors for HIV infection. Patients with pneumococcal bacteremia should be evaluated for HIV infection, especially in the absence of other underlying diseases that predispose to pneumococcal bacteremia.
我们回顾性地查阅了所有血培养肺炎链球菌呈阳性的成年患者的病历，以确定肺炎链球菌菌血症作为首发表现的HIV血清阳性患者的数量。我们还比较了HIV血清阳性患者与无HIV感染危险因素患者的肺炎球菌菌血症的临床表现、实验室数据及转归。通过查阅微生物学数据，确定了1987年1月至1989年4月期间加利福尼亚州北部两家急症综合医院所有血培养肺炎链球菌呈阳性的成年患者。一家医院收治退伍军人，另一家收治郊区贫困患者。41例肺炎球菌菌血症患者中有6例（15%）HIV血清阳性；5例在菌血症发作前不知为HIV血清阳性，第6例HIV感染无症状。无艾滋病患者发生肺炎球菌菌血症。与无HIV感染危险因素的菌血症患者相比，HIV血清阳性患者明显年轻，基础疾病明显较少，肺炎球菌菌血症的并发症也较少。肺炎球菌菌血症患者应评估是否感染HIV，尤其是在没有其他易患肺炎球菌菌血症的基础疾病的情况下。
