Fungal, Viral, and Parasitic Pneumonias Associated with Human Immunodeficiency Virus

Abstract Respiratory illness is an important cause of morbidity and mortality in patients with human immunodeficiency virus (HIV). The spectrum of pulmonary disease that can affect patients with HIV is wide and includes opportunistic infection with many fungal, viral, and parasitic organisms. This article reviews the clinical presentation; approach to diagnosis; and management of fungal, viral, and parasitic pneumonias that can develop in patients with HIV including respiratory disease caused by Aspergillus, Cryptococcus, Histoplasma, Coccidioides, Cytomegalovirus, Toxoplasma, and Strongyloides. Because clinical symptoms and radiographic patterns are often insensitive at distinguishing these pulmonary infections, this review particularly focuses on specific host risk factors and diagnostic testing to consider when approaching HIV patients with respiratory illness.

[1]  Benjamin J Park,et al.  Cryptococcal Antigen Screening and Early Antifungal Treatment to Prevent Cryptococcal Meningitis: A Review of the Literature , 2015, Journal of acquired immune deficiency syndromes.

[2]  D. Denning,et al.  British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases. , 2015, The Lancet. Infectious diseases.

[3]  C. Schaefer,et al.  Diversity and bioprospection of fungal community present in oligotrophic soil of continental Antarctica , 2015, Extremophiles.

[4]  N. Bearman,et al.  Indoor fungal diversity and asthma: a meta-analysis and systematic review of risk factors. , 2015, The Journal of allergy and clinical immunology.

[5]  T. Sorrell,et al.  Cryptococcus gattii Infections , 2014, Clinical Microbiology Reviews.

[6]  D. Stevens,et al.  Development and validation of a quantitative real-time PCR assay for the early diagnosis of coccidioidomycosis. , 2014, Diagnostic microbiology and infectious disease.

[7]  D. Horn,et al.  Clinical characteristics and outcomes in 303 HIV-infected patients with invasive fungal infections: data from the Prospective Antifungal Therapy Alliance registry, a multicenter, observational study , 2014, HIV/AIDS.

[8]  A. Bousvaros,et al.  2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. , 2014, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[9]  Ángel González,et al.  Diagnostic value of culture and serological tests in the diagnosis of histoplasmosis in HIV and non-HIV Colombian patients. , 2013, The American journal of tropical medicine and hygiene.

[10]  N. Ampel,et al.  Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis , 2013, Clinical Microbiology Reviews.

[11]  P. Vounatsou,et al.  Strongyloides stercoralis: Global Distribution and Risk Factors , 2013, PLoS neglected tropical diseases.

[12]  A. Caliendo,et al.  Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. , 2013, Transplantation.

[13]  A. Tsegaye,et al.  Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia , 2013, Parasites & Vectors.

[14]  C. Viscoli,et al.  Piperacillin/tazobactam (Tazocin™) seems to be no longer responsible for false-positive results of the galactomannan assay. , 2012, The Journal of antimicrobial chemotherapy.

[15]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[16]  K. Medical Human cystic echinococcosis:epidemiologic,zoonotic,clinical,diagnostic and therapeutic aspects , 2012 .

[17]  Z. P. Camargo,et al.  Paracoccidioidal Infection in HIV Patients at an Endemic Area of Paracoccidioidomycosis in Brazil , 2012, Mycopathologia.

[18]  N. E. Babady,et al.  A multicenter evaluation of tests for diagnosis of histoplasmosis. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[19]  S. Balajee,et al.  Evaluation of a Newly Developed Lateral Flow Immunoassay for the Diagnosis of Cryptococcosis , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  M. Cannon,et al.  Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection , 2010, Reviews in medical virology.

[21]  J. Perfect,et al.  Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[22]  V. Preedy,et al.  European Organization for Research and Treatment of Cancer , 2010 .

[23]  N. Ampel,et al.  Coccidioidomycosis in patients with HIV-1 infection in the era of potent antiretroviral therapy. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[24]  E. Shankar,et al.  Common protozoans as an uncommon cause of respiratory ailments in HIV-associated immunodeficiency. , 2009, FEMS immunology and medical microbiology.

[25]  M. Falagas,et al.  Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. , 2009, International journal for parasitology.

[26]  S. Antinori,et al.  Trends in the postmortem diagnosis of opportunistic invasive fungal infections in patients with AIDS: a retrospective study of 1,630 autopsies performed between 1984 and 2002. , 2009, American journal of clinical pathology.

[27]  K. Wannemuehler,et al.  Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS , 2009, AIDS.

[28]  A. Glasmacher,et al.  False positivity of the Aspergillus galactomannan Platelia ELISA because of piperacillin/tazobactam treatment: does it represent a clinical problem? , 2008, The Journal of antimicrobial chemotherapy.

[29]  D. Pegues,et al.  Diagnosis of coccidioidomycosis with use of the Coccidioides antigen enzyme immunoassay. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  J. Baddley,et al.  Histoplasmosis in HIV-infected patients in a southern regional medical center: poor prognosis in the era of highly active antiretroviral therapy. , 2008, Diagnostic microbiology and infectious disease.

[31]  Patricia Muñoz,et al.  Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[32]  P. Chandrasekar,et al.  False-positive Aspergillus galactomannan (GM) assay in histoplasmosis. , 2008, The Journal of infection.

[33]  R. Lockey,et al.  Typical levels of airborne fungal spores in houses without obvious moisture problems during a rainy season in Florida, USA. , 2008, Journal of investigational allergology & clinical immunology.

[34]  A. Apisarnthanarak,et al.  Non-neoformans Cryptococcal Infections: a Systematic Review , 2007, Infection.

[35]  S. Buckwalter,et al.  Detection of Coccidioides Species in Clinical Specimens by Real-Time PCR , 2006, Journal of Clinical Microbiology.

[36]  N. Ampel,et al.  Coccidioidomycosis as a Common Cause of Community-acquired Pneumonia , 2006, Emerging infectious diseases.

[37]  J. Fine,et al.  Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[38]  C. Feudtner,et al.  Hospitalizations for endemic mycoses: a population-based national study. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[39]  Kun‐Lun Huang,et al.  Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients. , 2006, Chest.

[40]  S. Antinori,et al.  Histoplasmosis Among Human Immunodeficiency Virus-Infected People in Europe: Report of 4 Cases and Review of the Literature , 2006, Medicine.

[41]  J. V. Vugt Risk Factors for Toxoplasma gondii Infection in Mothers of Infants With Congenital Toxoplasmosis: Implications for Prenatal Management and Screening , 2006 .

[42]  E. Levine Risk factors for Toxoplasma gondii infection in mothers of infants with congenital toxoplasmosis: implications for prenatal management and screening. , 2006, American journal of obstetrics and gynecology.

[43]  K. M. Chan,et al.  Disseminated strongyloidiasis: a retrospective study of clinical course and outcome , 2006, European Journal of Clinical Microbiology and Infectious Diseases.

[44]  B. Wanke,et al.  Paracoccidioidomycosis in patients with human immunodeficiency virus: review of 12 cases observed in an endemic region in Brazil. , 2005, The Journal of infection.

[45]  F. Castillo,et al.  Respiratory cryptosporidiosis: Case series and review of the literature , 1996, Infection.

[46]  R. Lerch,et al.  Aspergillus endocarditis and myocarditis in a patient with the acquired immunodeficiency syndrome (AIDS) , 1990, Virchows Archiv A.

[47]  P. Connolly,et al.  Antigen Assay with the Potential To Aid in Diagnosis of Blastomycosis , 2004, Journal of Clinical Microbiology.

[48]  T. Nutman,et al.  Strongyloides stercoralis in the Immunocompromised Population , 2004, Clinical Microbiology Reviews.

[49]  E. Graviss,et al.  The changing epidemiology of cryptococcosis: an update from population-based active surveillance in 2 large metropolitan areas, 1992-2000. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[50]  H. Auer,et al.  European Echinococcosis Registry: Human Alveolar Echinococcosis, Europe, 1982–2000 , 2003, Emerging infectious diseases.

[51]  E. Brizendine,et al.  Cellular Immune Response in HIV‐Infected Patients With Histoplasmosis , 2002, Journal of acquired immune deficiency syndromes.

[52]  Jennifer I. Lim,et al.  Characteristics of patients with cytomegalovirus retinitis in the era of highly active antiretroviral therapy. , 2002, American journal of ophthalmology.

[53]  S. Berk,et al.  Diagnosis of Strongyloides stercoralis infection. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[54]  S J Lin,et al.  Aspergillosis case-fatality rate: systematic review of the literature. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[55]  M. Thellier,et al.  [Disseminated strongyloidiasis]. , 2001, Presse medicale.

[56]  P. Sax,et al.  Central Nervous System Aspergillosis in Patients with Human Immunodeficiency Virus Infection Report of 6 Cases and Review , 2000, Medicine.

[57]  C. Woods,et al.  Coccidioidomycosis in human immunodeficiency virus-infected persons in Arizona, 1994-1997: incidence, risk factors, and prevention. , 2000, The Journal of infectious diseases.

[58]  Kielstein,et al.  Occurrence of Cryptococcus spp. in excreta of pigeons and pet birds , 2000, Mycoses.

[59]  J. Latgé,et al.  Aspergillus fumigatus and Aspergillosis , 1999, Clinical Microbiology Reviews.

[60]  J. Erasmus,et al.  Opportunistic fungal pneumonia. , 1999, Journal of thoracic imaging.

[61]  S. Kralovic,et al.  Utility of Routine Testing of Bronchoalveolar Lavage Fluid for Cryptococcal Antigen , 1998, Journal of Clinical Microbiology.

[62]  P. Kvale,et al.  Risk Factors and Outcomes Associated With Identification of Aspergillus in Respiratory Specimens From Persons With HIV Disease , 1998 .

[63]  J. Rich,et al.  Pulmonary aspergillosis and invasive disease in AIDS: review of 342 cases. , 1998, Chest.

[64]  E. Weitzenblum,et al.  Recurrent varicella pneumonia complicating an endogenous reactivation of chickenpox in an HIV-infected adult patient. , 1998, The European respiratory journal.

[65]  G. Barbarini,et al.  Asymptomatic respiratory tract microsporidiosis due to Encephalitozoon hellem in three patients with AIDS. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[66]  R. Kerschmann,et al.  Pulmonary aspergillosis in acquired immune deficiency syndrome: autopsy study of an emerging pulmonary complication of human immunodeficiency virus infection. , 1997, Human pathology.

[67]  D. Smith,et al.  Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[68]  W. Rom,et al.  Pulmonary aspergilloma and AIDS. A comparison of HIV-infected and HIV-negative individuals. , 1997, Chest.

[69]  F. Allerberger,et al.  Alveolar echinococcosis of the liver in a six-year-old girl with acquired immunodeficiency syndrome. , 1997, The Journal of pediatrics.

[70]  R. Matthay,et al.  Cytomegalovirus as a primary pulmonary pathogen in AIDS. , 1997, Chest.

[71]  P. Ambroise‐Thomas,et al.  Pulmonary toxoplasmosis in patients infected with human immunodeficiency virus: a French National Survey. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[72]  D. Musher,et al.  Diagnosing and treating cytomegalovirus pneumonia in patients with AIDS. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[73]  T. Duong,et al.  Infection due to Penicillium marneffei, an emerging pathogen: review of 155 reported cases. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[74]  P. Hopewell,et al.  Presentation of AIDS-related pulmonary Kaposi's sarcoma diagnosed by bronchoscopy. , 1996, American journal of respiratory and critical care medicine.

[75]  S. B. Ferreira,et al.  Strongyloidiasis in patients with hematologic malignancies. , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[76]  R. Baughman,et al.  The relationship between cytomegalovirus retrieved by bronchoalveolar lavage and mortality in patients with HIV. , 1995, Chest.

[77]  C. Farber,et al.  Herpes simplex virus tracheitis in a patient with the acquired immunodeficiency syndrome. , 1994, The European respiratory journal.

[78]  J. Celedón,et al.  Systemic Strongyloidiasis in Patients Infected with the Human Immunodeficiency Virus: A Report of 3 Cases and Review of the Literature , 1994, Medicine.

[79]  D. McCauley,et al.  Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. , 1994, Radiology.

[80]  K. Nelson,et al.  Disseminated Penicillium marneffei infection in Southeast Asia , 1994, The Lancet.

[81]  R. Witzig,et al.  Blastomycosis and Human Immunodeficiency Virus: Three New Cases and Review , 1994, Southern medical journal.

[82]  J. D. de Jong,et al.  Antibody response to influenza, tetanus and pneumococcal vaccines in HIV‐seropositive individuals in relation to the number of CD4+ lymphocytes , 1994, AIDS.

[83]  N. Ampel,et al.  Bronchoscopic diagnosis of pulmonary coccidioidomycosis. Comparison of cytology, culture, and transbronchial biopsy. , 1994, Diagnostic microbiology and infectious disease.

[84]  L. Sider,et al.  Pulmonary Manifestations of Cryptococcosis in Patients with AIDS: CT Features , 1994, Journal of thoracic imaging.

[85]  M. Sans,et al.  [Varicella pneumonia in adults infected by HIV-1. Presentation of 2 cases]. , 1994, Enfermedades infecciosas y microbiologia clinica.

[86]  S. Fullerton,et al.  Use of a clinical laboratory database to estimate Toxoplasma seroprevalence among human immunodeficiency virus-infected patients. Overcoming bias in secondary analysis of clinical records. , 1994, Archives of pathology & laboratory medicine.

[87]  I. Frank,et al.  Pulmonary aspergillosis in patients with AIDS. Clinical and radiographic correlations. , 1994, Chest.

[88]  C. Kemper,et al.  Ulcerative and plaque-like tracheobronchitis due to infection with Aspergillus in patients with AIDS. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[89]  J. Phair,et al.  Prevalence of Toxoplasma infection in a cohort of homosexual men at risk of AIDS and toxoplasmic encephalitis. , 1993, Journal of acquired immune deficiency syndromes.

[90]  E. Fishman,et al.  Thoracic Kaposi Sarcoma in AIDS: CT Findings , 1993, Journal of computer assisted tomography.

[91]  R. Shafer,et al.  Blastomycosis in patients with the acquired immunodeficiency syndrome. , 1992, Annals of internal medicine.

[92]  G. Filice,et al.  Pulmonary toxoplasmosis: a review. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[93]  A. Gurtman,et al.  Renal aspergilloma: an unusual cause of infection in a patient with the acquired immunodeficiency syndrome. , 1992, The American journal of medicine.

[94]  G. Sarosi,et al.  Disseminated histoplasmosis in patients infected with human immunodeficiency virus. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[95]  E. Hilton,et al.  The Strongyloides hyperinfection syndrome. , 1992, New York state journal of medicine.

[96]  D. Armstrong,et al.  Aspergillus species colonization and invasive disease in patients with AIDS. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[97]  D. Richman,et al.  Impact of Pneumocystis carinii and cytomegalovirus on the course and outcome of atypical pneumonia in advanced human immunodeficiency virus disease. , 1992, The Journal of infectious diseases.

[98]  P. Arnow,et al.  Endemic and epidemic aspergillosis associated with in-hospital replication of Aspergillus organisms. , 1991, The Journal of infectious diseases.

[99]  J. K. Frenkel,et al.  Respiratory and enteric cryptosporidiosis in humans. , 1991, Archives of pathology & laboratory medicine.

[100]  J. Goldsmith,et al.  Atypical pulmonary diseases associated with AIDS. , 1991, Chest.

[101]  M. Gompels,et al.  Disseminated strongyloidiasis in AIDS: uncommon but important. , 1991, AIDS.

[102]  S. Kamholz,et al.  Utility of bronchoscopic sampling techniques for cryptococcal disease in AIDS. , 1991, Chest.

[103]  D. Dieterich,et al.  Cytomegalovirus colitis in AIDS: presentation in 44 patients and a review of the literature. , 1991, Journal of acquired immune deficiency syndromes.

[104]  S. Kamholz,et al.  Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS. , 1990, Chest.

[105]  M. Zeckel,et al.  Disseminated Histoplasmosis in the Acquired Immune Deficiency Syndrome: Clinical Findings, Diagnosis and Treatment, and Review of the Literature , 1990, Medicine.

[106]  N. Ampel,et al.  Coccidioidomycosis during Human Immunodeficiency Virus Infection: A Review of 77 Patients , 1990, Medicine.

[107]  F. Derouin,et al.  Prevalence of pulmonary toxoplasmosis in HIV-infected patients. , 1990, AIDS.

[108]  R. Larsen,et al.  Seronegative disseminated coccidioidomycosis in patients with HIV infection. , 1990, AIDS.

[109]  R. Miller,et al.  Cytomegalovirus in the lungs of patients with AIDS. Respiratory pathogen or passenger? , 1990, The American review of respiratory disease.

[110]  R. Baughman,et al.  Cytomegalovirus in the bronchoalveolar lavage fluid of patients with AIDS. , 1990, Chest.

[111]  J. Murray,et al.  Pulmonary infectious complications of human immunodeficiency virus infection. Part II. , 1990, The American review of respiratory disease.

[112]  B. Gazzard,et al.  The significance of the detection of cytomegalovirus in the bronchoalveolar lavage fluid in AIDS patients with pneumonia. , 1990, AIDS.

[113]  D. Naidich,et al.  Kaposi's sarcoma. CT-radiographic correlation. , 1989, Chest.

[114]  J. Wallace,et al.  Cytomegalovirus pneumonitis in patients with AIDS. Findings in an autopsy series. , 1987, Chest.

[115]  A. Verghese,et al.  Clinical and epidemiologic features of strongyloidiasis. A prospective study in rural Tennessee. , 1987, Archives of internal medicine.

[116]  C. Henschke,et al.  Intrathoracic Kaposi sarcoma in AIDS patients: radiographic-pathologic correlation. , 1987, Radiology.

[117]  J. Davis,et al.  Epidemiologic aspects of blastomycosis, the enigmatic systemic mycosis. , 1986, Seminars in respiratory infections.

[118]  R. Tewari,et al.  Diagnosis of disseminated histoplasmosis by detection of Histoplasma capsulatum antigen in serum and urine specimens. , 1986, The New England journal of medicine.

[119]  B. Luft,et al.  Toxoplasmic encephalitis in patients with acquired immune deficiency syndrome. , 1984, JAMA.

[120]  D. Armstrong,et al.  Central-Nervous-System Toxoplasmosis in Homosexual Men and Parenteral Drug Abusers , 1984 .

[121]  P. Walzer,et al.  Epidemiologic features of Strongyloides stercoralis infection in an endemic area of the United States. , 1982, The American journal of tropical medicine and hygiene.

[122]  J. Enders,et al.  Infectious Diseases Society of America. , 1969, Antimicrobial agents and chemotherapy.

[123]  C. Palmer,et al.  Prevalence of sensitivity to coccidioidin, with special reference to specific and nonspecific reactions to coccidioidin and to histoplasmin. , 1957, Diseases of the chest.

[124]  F. Ellis,et al.  Pulmonary cryptococcosis. , 1957, The New England journal of medicine.