Clinical and Diagnostic findings of Pleural Involvement  in Patients having Human Immunodeficiency Virus (HIV)  Infection from Western part of India

Ramakant Dixit; Lokendra  Dave; Rakesh C. Gupta

Ramakant Dixit Professor & Unit Head, Department of Respiratory Medicine, J. L. N. Medical College, Ajmer
Lokendra Dave Professor, Department of Respiratory Medicine, Gandhi Medical College, Bhopal.
Rakesh C. Gupta Former Senior Professor and Head, Department of Respiratory Medicine, J. L. N. Medical College, Ajmer .

Keywords: HIV infection, pleural effusion, pneumothorax.

Abstract

ABSTRACT

Background: Pleural effusions are not uncommon in patients with HIV infection, however; there is paucity of data on type and description of pleural involvement in HIV infected patients from countries like India where the disease is highly rampant. Objectives/aims: Present study describes the clinical, radiological, pathological and bacteriological profile of pleural involvement in HIV infected patients.
Methods: Patients with HIV infection having pleural effusion and/or pneumothorax were subjected to detailed clinical evaluation followed by in depth diagnostic workup including radiological assessment, sputum examination, pleurocentesis, pleural fluid biochemistry, cytology, smear and/or culture for bacteria, mycobacteria, fungi, pleural biopsy, tuberculin skin testing etc.

Results: Pleural involvement occurred in 34 out of 150 (22.6%) patients with HIV infection. Pleural effusion was seen in 32 (94.1%) cases and pneumothorax in two cases. All pleural effusions were exudates in nature. In 20(58.8%) cases, underlying pulmonary parenchymal disease was evident. Pleural involvement was more common on left side (47%). Tuberculosis was the underlying cause of pleural involvement in 28(82.3%) cases. Four (11.7%) cases had empyema thoracis.
Conclusion: Tuberculosis is the most common cause of pleural effusion in patients having HIV infection followed by bacterial pneumonia from this part of country.