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Legionellosis in patients with HIV infection

Legionellose bei Patienten mit HIV-Infektion

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Summary

During the five-year period 1984–1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation ofLegionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from autopsies were also examined. The diagnostic methods used were a direct immunofluorescence assay (DFA) for the detection ofLegionella antigen, and culture on buffered charcoal yeast extract (BCYE-α) media. All specimens were also examined for the presence of other bacterial lung pathogens, and all BAL specimens additionally forPneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive forLegionella species. Dual infection withLegionella andP. carinii occurred in two patients. Clinical data of the six patients are presented, and currently used methods for diagnosing legionellosis are discussed.

Zusammenfassung

In einem Zeitraum von fünf Jahren (1984–1988) erhielten wir 192 Proben von 180 mit dem menschlichen Immunschwächevirus (HIV) infizierten Patienten zur Untersuchung aufLegionella-Infektion. Die meisten Proben (84%) waren Bronchoalveolarlavageflüssigkeit, außerdem wurde durch Trachealabsaugung gewonnenes Material und autoptisch entnommenes Gewebe untersucht. Zum Nachweis von Legionella-Antigen wurde ein direkter Immunfluoreszenztest (DFA) verwendet; die Kultivierung erfolgte auf gepufferten Kohle-Hefeextrakt-(BCYE-α)-Medien. Alle Proben wurden auch auf andere bakterielle Erreger von Atemwegsinfektionen untersucht; Bronchoalveolarlavage-Proben wurden in allen Fällen aufPneumocystis carinii und Mykobakterien getestet. Es zeigte sich, daß die Legionellose bei HIV-infizierten Patienten nicht häufig vorkommt. Nur sechs der Proben (3%), die von sechs Patienten stammten, waren im DFA positiv; in keinem Fall konntenLegionella-Spezies kultiviert werden. Eine Doppelinfektion mitLegionella undP. carinii wurde bei zwei Patienten festgestellt. Die klinischen Daten der sechs Patienten werden mitgeteilt und derzeit gebräuchliche Methoden zur Legionellose-Diagnostik diskutiert.

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Authors and Affiliations

  1. Dept. of Clinical Microbiology 8223, Statens Seruminstitut, Juliane Mariesvej 28, DK-2100, Copenhagen

    J. M. Bangsborg M. D. & B. Bruun M. D., D. Sc.

  2. Rigshospitalet, Dept. of Infectious Diseases 7722, Tagensvej 20, DK-2100, Copenhagen

    B. N. Jensen M. D.

  3. Dept. of Clinical Microbiology, Frederiksberg Hospital, DK-2000, Frederiksberg, Denmark

    A. Friis-Møller M. D.

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Bangsborg, J.M., Jensen, B.N., Friis-Møller, A. et al. Legionellosis in patients with HIV infection. Infection 18, 342–346 (1990). https://doi.org/10.1007/BF01646400

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