Milgrim L M, Rubin J S, Rosenstreich D L, Small C B
Department of Otolaryngology, Montefiore Medical Center, Bronx, New York 10467.
J Otolaryngol. 1994 Dec;23(6):450-3.
The majority of patients with human immunodeficiency virus (HIV) infection will develop acute sinusitis. This may be a single episode, or may be the beginning of a long course of recurrent sinusitis, of which the etiology is not yet well understood. A retrospective study of cultures from antral washings was conducted to determine the organisms that were more commonly isolated in patients with HIV infection and sinusitis. Forty-seven organisms were isolated from the sinus cultures of 41 HIV-positive patients. The most common organisms isolated were Streptococcus pneumoniae (19%), Streptococcus viridans (19%), and Pseudomonas aeruginosa (17%). Pseudomonas aeruginosa is an atypical cause of acute sinusitis in the general population but was found to be an important pathogen in our HIV-infected patients. Other atypical organisms were also isolated, including Listeria monocytogenes and Candida albicans. It is important to recognize that atypical organisms must be considered if an HIV-infected patient with sinusitis does not respond to initial antibiotic therapy. A discussion follows emphasizing the need for prompt diagnosis and treatment of sinusitis in HIV infection.
大多数人类免疫缺陷病毒（HIV）感染者会患上急性鼻窦炎。这可能是单次发作，也可能是复发性鼻窦炎漫长病程的开端，其病因尚未完全明确。对鼻窦灌洗培养物进行了一项回顾性研究，以确定在HIV感染合并鼻窦炎患者中更常分离出的微生物。从41例HIV阳性患者的鼻窦培养物中分离出47种微生物。分离出的最常见微生物是肺炎链球菌（19%）、草绿色链球菌（19%）和铜绿假单胞菌（17%）。铜绿假单胞菌在普通人群中是急性鼻窦炎的非典型病因，但在我们的HIV感染患者中被发现是一种重要病原体。还分离出了其他非典型微生物，包括单核细胞增生李斯特菌和白色念珠菌。重要的是要认识到，如果HIV感染合并鼻窦炎的患者对初始抗生素治疗无反应，必须考虑非典型微生物。接下来将进行讨论，强调在HIV感染中对鼻窦炎进行及时诊断和治疗的必要性。
