Pneumothorax in human immunodeficiency virus infected patients

• Published in: Cirugia Española Vol. 84; no. 4; p. 221
• Main Authors: Cabrera-Cordero, José A, Adefna-Pérez, Radamés I, Leal-Mursulí, Armando, Castellanos-González, Juan Antonio, Izquierdo-Lara, Francoise T, Cabrera-Alfonso, Suset
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.10.2008
• Subjects: Adolescent; Adult; AIDS-Related Opportunistic Infections - mortality; Bronchopneumonia - etiology; Bronchopneumonia - mortality; Catheterization, Central Venous - adverse effects; Female; HIV Infections - complications; HIV Infections - mortality; Humans; Immunocompromised Host; Male; Pneumocystis carinii; Pneumonia, Pneumocystis - etiology; Pneumonia, Pneumocystis - mortality; Pneumothorax - etiology; Pneumothorax - mortality; Postoperative Complications; Prognosis; Time Factors
• ISSN: 0009-739X

The respiratory system still continues to be a common place which deteriorates in HIV patients. Among the signs and symptoms, is the occurrence of a pneumothorax due to trauma and infections and is a cause of aggravation for these patients. The present study attempts to identify and characterise the behaviour of a group of variables in HIV patients with this complication. An observational, descriptive case series study was carried out. The desired variables were obtained from clinical records. Of the total number, 91.67% were males, and the mean age was 32.17 years. The main causes of pneumothorax were infections, particularly due to Pneumocystis jirovecii and deep venous catheterisation. A persistent statistically significant air leak was present in 33.3% of patients and two cases of pleural sepsis. Four patients died, all with acute respiratory failure and bacterial bronchopneumonia. The majority were males in the third decade of life, AIDS patients. The main causes of the pneumothorax were infections and catheterisation of the subclavian vein. Immunodepression played a significant prognostic role in the progression and outcome of the patient. Minimum pleurotomy continues to be the first treatment option in these patients, due to their precarious general state which contraindicates a major procedure. The most frequent complication was the persistent air leak, being a significant indicator of a poor prognosis in the progress of these patients. Causes of death such as acute respiratory failure and bilateral bronchopneumonia prevailed.