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AIDS related pneumonia

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 23 December 2011, last major update August 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Clinical features

● Lung disease is most common cause of morbidity and mortality in AIDS patients
● Diagnose infection or mimickers with bronchoalveolar lavage, transbronchial biopsy or open lung biopsy
● Non-specific features resemble DIP or lymphocytic interstitial pneumonia
● Patients often have multiple infections
● Lung biopsies in AIDS patients should routinely be stained for pneumocystis, fungi and mycobacteria
● Characteristically cavitary lesions: Staphylococcus, fungi (Candida, Aspergillus, Cryptococcus [J Acquir Immune Defic Syndr 2010;54:269], Histoplasma, Blastomyces), Mycobacterium tuberculosis, Mycobacterium avium complex, other non-tuberculous mycobacteria; Rhodococcus equi, Fusarium, Pseudallescheria
● AIDS patients also have infections from CMV, Pneumocystis jeroveci (formerly Pneumocystis carinii), toxoplasma, microsporidia, herpesvirus types 1 and 2, adenovirus, Strep. pneumonia, H. influenza, gram negative rods, Legionella pneumophilia, cryptosporidium, zygomycetes, herpes varicella zoster, Penicillium marneffei (patients from Southeast Asia), and bartonella
● Rarely pulmonary alveolar proteinosis (J Med Case Reports 2011 Feb 1;5(1):46)
● Non-infectious causes of pulmonary infiltrates: Kaposiís sarcoma, drug reaction, primary lung cancer, non-Hodgkin's lymphoma
● Multiple infections, and infections with concurrent malignancy are common in AIDS patients

Micro images

CMV and pulmonary alveolar proteinosis


Additional References

Kradin RL (ed), Diagnostic Pathology of Infectious Disease. Saunders; 2010

End of Lung-nontumor > Infections > AIDS related pneumonia

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