Wan-Ling Cheng1, Wen-Chien Ko2, Nan-Yao Lee1, Chia-Ming Chang2, Ching-Chi Lee1, Ming-Chi Li1, Chia-Wen Li3. 1. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan. 2. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan. 3. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan. Electronic address: li.cw29@gmail.com.
Abstract
OBJECTIVE: Pneumomediastinum is a rare complication of opportunistic infections in HIV-infected patients. However, the relationship between the causative pathogens and the prognosis is unclear. We report the case of a patient with AIDS presenting with community-acquired pneumonia complicated by pneumomediastinum. The cases of a further 10 HIV-infected patients with pneumomediastinum reported in the English language literature are reviewed. METHODS: PubMed was searched for cases of HIV-infected patients with pneumomediastinum published in the English language literature. RESULTS: Pneumocystis jirovecii is the most common pathogen causing pneumonia and concurrent pneumomediastinum in HIV-infected patients. Only one of the identified cases was caused by cytomegalovirus. Excluding the two cases with incomplete information, the overall mortality rate in the remaining nine cases was 55.5%. CONCLUSION: In HIV-infected patients, Pneumocystis jirovecii pneumonia can occasionally present as pneumomediastinum. In such cases, adequate appropriate antimicrobial therapy is needed due to the high mortality rate.
OBJECTIVE: Pneumomediastinum is a rare complication of opportunistic infections in HIV-infectedpatients. However, the relationship between the causative pathogens and the prognosis is unclear. We report the case of a patient with AIDS presenting with community-acquired pneumonia complicated by pneumomediastinum. The cases of a further 10 HIV-infectedpatients with pneumomediastinum reported in the English language literature are reviewed. METHODS: PubMed was searched for cases of HIV-infectedpatients with pneumomediastinum published in the English language literature. RESULTS:Pneumocystis jirovecii is the most common pathogen causing pneumonia and concurrent pneumomediastinum in HIV-infectedpatients. Only one of the identified cases was caused by cytomegalovirus. Excluding the two cases with incomplete information, the overall mortality rate in the remaining nine cases was 55.5%. CONCLUSION: In HIV-infectedpatients, Pneumocystis jirovecii pneumonia can occasionally present as pneumomediastinum. In such cases, adequate appropriate antimicrobial therapy is needed due to the high mortality rate.
Authors: Anna Cancelliere; Giada Procopio; Maria Mazzitelli; Elena Lio; Maria Petullà; Francesca Serapide; Maria Chiara Pelle; Chiara Davoli; Enrico Maria Trecarichi; Carlo Torti Journal: Clin Case Rep Date: 2021-04-09