Pneumonia por Pneumocystis e citomegalovírus no doente VIH – A propósito de dois casos clínicos

AbstractCytomegalovirus 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.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 Pneumocystis jirovecii 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.Rev Port Pneumol 2008; XIV (1): 151-15