APIK Journal of Internal Medicine | 2019
Necessity for sustained efforts to eliminate measles worldwide: An appeal for global leaders
Abstract
I read with interest the case report by Mimethashree et al. published in April–June 2019 issue of the Journal of Internal Medicine-Research, Reviews, Reports.[1] The authors described an unusual case of Escherichia coli infection causing cavitary necrotizing pneumonia (NP) in an Indian patient.[1] I assume that the rarity of that pathogen to cause extensive pulmonary cavitation should alert the authors to take into consideration low immune status in the studied patient. Among low immune states, infection with human immunodeficiency virus (HIV) has great importance. It is explicit that due to weak immunity, patients with HIV infection are at increased risk to systemic infections with unusual pathogens compared to patients with an intact immune system. In fact, cavitary pulmonary diseases have been reported among patients with HIV infection that tended to be infectious and generally polymicrobial in nature.[2] In India, HIV infection is an alarming health problem. The available data pointed to 0.26% HIV seroprevalence compared with a global average of 0.2%.[3] Regrettably, HIV status was not assessed in the studied patient as the employed diagnostic workup did not include HIV testing. I assume that the underlying HIV infection ought to be seriously considered in the studied patient, and implementing the diagnostic set of viral overload and CD4 lymphocyte count measurements would have to be taken into account. If that set was contemplated and it disclosed HIV seropositivity, the case in question could be obviously regarded a novel case report of E. coli-associated NP in HIV-positive individuals in the literature.