To the Editor.—
The mucous membranes appear to be particularly vulnerable to opportunistic infections in patients with the acquired immunodeficiency syndrome (AIDS). Such infections may arise either from the external environment or by extension from a systemic focus. We wish to report a patient with AIDS and a chronic rhinitis and sinusitis due to cytomegalovirus (CMV) that led to an erroneous impression of CMV pneumonitis.
Report of a Case.—
A 33-year-old homosexual man was evaluated for interstitial pneumonitis. There was a history of fever, weight loss, intermittent diarrhea, anorectal herpes infection, and previous admissions for an unspecified pneumonia and staphylococcal sepsis—the latter felt to be caused by nasal vestibulitis. On the second hospital day, pneumocystis pneumonia was disgnosed by bronchoalveolar lavage. No biopsies were performed.The patient was treated with trimethoprim sulfate and had clinical resolution of symptoms, although temperatures to 38.8 °C continued. The patient was anemic and lymphopenic.
Kotler DP, Scholes JV, Jacob AL, Edelheit W. Disseminated CMV Infection. JAMA. 1985;253(21):3093-3094. doi:10.1001/jama.1985.03350450065018