Severe respiratory complications in acquired immunodeficiency syndrome
Barberá, J.A.; Torres, A.; Ussetti, P.; Xaubet, A.; Ramírez, J.; Latorre, X.; Rodríguez Roisín, R.; Agustí Vidal, A.
Medicina Clinica 88(8): 305-310
1987
ISSN/ISBN: 0025-7753 PMID: 3494174 Document Number: 291328
The five first patients with acquired immunodeficiency syndrome (AIDS) requiring admission to an Intensive Care Unit of the Hospital Clinic i Provincial in Barcelona due to acute severe respiratory failure are reported in the present article. All patients were male, whit ages ranging between 22 and 62 years. Two were homosexual, one was bisexual, one was a narcotic addict and one was hemophilic. Pulmonary involvement was due to Pneumocystis carinii pneumonia (4 cases), cytomegalovirus pneumonia (2 cases), Kaposi's sarcoma (1 case), and bacterial pneumonia (1 case). Four patients required tracheal intubation and mechanical ventilation, and in two the criteria for the diagnosis of adult respiratory distress syndrome were met. All patients died betewen 8 and 19 days after admission, two with progressive respiratory failure and the remaining three with multiorganic failure. Necropy was performed in three cases, whith confirmation of the diagnosis of P. carnii pneumonia; in addition, necropy detected previously unsuspected cytomegalovirus pneumonia and Kaposi's sarcoma of the lung. Emphasis is made on the need for early diagnosis and therapy as a means to avoid the development of respiratory failure; the latter is characterized by a high mortality in AIDS.