Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos
Pneumocystis and cytomegalovirus pneumonia in HIV patients – Two clinical cases
Sofia Lourenço1,
, Marta Amaral1, Raquel Almeida1, Paulo Marcelino2, Susan Marum2, M.ª Adelaide Milheiro3, Judite Oliveira4, Luís Mourão5,6
Corresponding author
sofilourenco@hotmail.com
Correspondência: Hospital de Curry Cabral, Unidade de Cuidados Intensivos, Rua da Beneficência, 8, 1069-166 Lisboa.
Correspondência: Hospital de Curry Cabral, Unidade de Cuidados Intensivos, Rua da Beneficência, 8, 1069-166 Lisboa.
1 Interna do Internato Complementar de Medicina Interna
2 Assistente Hospitalar de Medicina Interna, subespecialista em Medicina Intensiva
3 Assistente Hospitalar Graduado de Anatomia Patológica
4 Assistente Hospitalar Graduado de Medicina Interna
5 Assistente Hospitalar Graduado de Medicina Interna, Director de Serviço
6 Hospital de Curry Cabral, Unidade de Cuidados Intensivos
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"clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec159423" "palabras" => array:3 [ 0 => "Citomegalovírus" 1 => "pneumonia" 2 => "VIH" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec159424" "palabras" => array:3 [ 0 => "Cytomegalovirus" 1 => "pneumonia" 2 => "HIV" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nos doentes com infecção pelo vírus da imunodeficiência humana (VIH) o citomegalovírus torna-se um agente de doença importante quando existe imunossupressão avançada. O seu papel como agente de doença pulmonar neste contexto tem sido amplamente debatido. Nos doentes com pneumocistose, a presença do citomegalovírus no pulmão não parece conferir pior prognóstico, excepto nos que recebem terapêutica adjuvante com corticóides.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Os autores apresentam dois casos de doentes com infecção VIH e imunossupressão avançada, admitidos na unidade de cuidados intensivos por insuficiência respiratória. Em ambos houve isolamento de <span class="elsevierStyleItalic">Pneumocystis jirovecii</span> no lavado broncoalveolar. Apesar da terapêutica instituída ambos vieram a falecer. A biópsia pulmonar <span class="elsevierStyleItalic">post mortem</span> mostrou, nos dois casos, a presença de <span class="elsevierStyleItalic">Pneumocystis</span> e inclusões por citomegalovírus. Perante este achado tecem-se algumas considerações sobre o papel do citomegalovírus como agente de pneumonia na SIDA e sobre o seu significado como co-infectante na pneumocistose, sobretudo nos casos de falência terapêutica.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cytomegalovirus is capable of causing disease in immunocompromised patients. In people infected by the Human Immunodeficiency Virus (HIV) it becomes an important agent when there is advanced immunosupression. Its role as a pulmonary pathogen in these patients has been questioned. In the case of pneumocystosis the presence of Cytomegalovirus doesn’t seem to worsen prognosis, except in cases where corticosteroids are used.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Authors present two cases of patients with HIV infection and advanced immunosupression who were admitted in the intensive care unit for respiratory failure. In both <span class="elsevierStyleItalic">Pneumocystis jirovecii</span> was isolated from bronco-alveolar lavage. Despite of therapy both patients died from refractory hypoxemia. Pulmonary biopsies performed post mortem revealed presence of Pneumocystis and Cytomegalovirus inclusion bodies. Considering this finding the role of Cytomegalovirus as a cause of pneumonia in AIDS is discussed, highlighting its impact on the outcome of patients with pneumocystosis, especially in cases of therapeutic failure.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV disease: AIDS related disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.S. Fauci" 1 => "H.C. Lane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Harrison's Principals of Internal Medicine" "paginaInicial" => "1076" "paginaFinal" => "1139" "edicion" => "16<span class="elsevierStyleSup">th</span> edition." "serieFecha" => "2005" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary Cytomegalovirus infection in immunocompromised patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Tamm" 1 => "P. Traenkle" 2 => "B. Grilli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2001" "volumen" => "119" "paginaInicial" => "838" "paginaFinal" => "843" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11243966" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cytomegalovirus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.A. Jacobson" 1 => "J. Mills" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Chest Med" "fecha" => "1988" "volumen" => "9" "numero" => "3" "paginaInicial" => "443" "paginaFinal" => "448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2842110" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic markers of short-term mortality in AIDS-associated Pneumocystis carinii pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Benfield" 1 => "J. Helweg-Larsen" 2 => "D. Bang" 3 => "J. Junge" 4 => "J. Lundgren" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2001" "volumen" => "119" "paginaInicial" => "844" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11243967" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary cytomegalovirus as a primary pulmonary pathogen in AIDS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.B. Waxman" 1 => "S.J. Goldie" 2 => "H. Brett-Smith" 3 => "Matthay RA" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1997" "volumen" => "111" "paginaInicial" => "128" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8996006" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary manifestations of HIV/AIDS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Huang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Cecil Textbook of Medicine" "paginaInicial" => "2158" "paginaFinal" => "2168" "edicion" => "22<span class="elsevierStyleSup">nd</span> edition" "serieFecha" => "2004" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features and outcomes of HIV-related cytomegalovirus pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Salomon" 1 => "T. Gomez" 2 => "D.C. Perlman" 3 => "L. Laya" 4 => "C. Eber" 5 => "D. Mildvan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "AIDS" "fecha" => "1997" "volumen" => "11" "numero" => "3" "paginaInicial" => "319" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9147423" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differences and similarities of cytomegalovirus and pneumocystis pneumonia in HIV-negative immunocompromised patients- thin section CT-morphology in the early phase of the disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.N. Vogel" 1 => "H. Brodoefel" 2 => "T. Hierl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/0007-1285-64-767-1015" "Revista" => array:3 [ "tituloSerie" => "Br J Radiol" "fecha" => "2006" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1742581" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cytomegalovirus disease in the era of highly active antiretroviral therapy (HAART)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Steininger" 1 => "E. Puchhammer-Stockl" 2 => "T. Popow-Kraupp" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcv.2006.03.005" "Revista" => array:7 [ "tituloSerie" => "J Clin Virol" "fecha" => "2006" "volumen" => "37" "numero" => "1" "paginaInicial" => "1" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16675299" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An Official ATS Workshop Summary: Recent Advances and Future Directions in Pneumocystis Pneumonia (PCP)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ATS Pneumocystis Workshop Participants" "etal" => false "autores" => array:4 [ 0 => "L. Huang" 1 => "A. Morris" 2 => "A.H. Limper" 3 => "J.M. Beck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1513/pats.200602-015MS" "Revista" => array:7 [ "tituloSerie" => "Proc Am Thorac Soc" "fecha" => "2006" "volumen" => "3" "numero" => "8" "paginaInicial" => "655" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17065370" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/21735115/0000001400000001/v1_201305151449/S2173511509702490/v1_201305151449/pt/main.assets" "Apartado" => array:4 [ "identificador" => "9550" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Report/Caso Clínico" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001400000001/v1_201305151449/S2173511509702490/v1_201305151449/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509702490?idApp=UINPBA00004E" ]
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ISSN: 21735115Original language: Portuguese
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