Concurrent PCP and TB pneumonia in HIV infected patients

Abstract

We aimed to assess the incidence and clinical characteristics of patients with HIV infection with concurrent Pneumocystis pneumonia (PCP) and tuberculosis (TB). We carried out a retrospective record review of HIV infected patients admitted with pulmonary TB and PCP during the same hospital admission at a large county hospital in Miami, from 1995 to 2004. 2651 patients with HIV infection and possible TB or PCP were identified. There were 99 cases of PCP (81 presumptive and 18 confirmed) and 35 were new cases of TB. There were 17 patients who had a new, concurrent diagnosis of pulmonary TB and PCP. Approximately half of these patients were unaware of their HIV infections and half of them had a negative AFB in sputum. Most were men and had a CD4 count less than 100 cells/mm³. Chest X-ray disclosed bilateral infiltrates in most of the cases. All but 2 survived the hospital admission. Thus, concurrent TB and PCP in HIV infected patients were not uncommon in this large county hospital in Miami, Florida in the studied period, but its diagnosis was challenging.