E. Afane Ze

Caractéristiques cliniques, bactériologiques et évolutives de la pleurésie purulente non-tuberculeuse chez les patients adultes séropositifs et séronégatifs au VIH à Yaoundé, Cameroun

OBJECTIVE To investigate the impact of HIV infection on clinical presentation, etiologic features and outcome of non-tuberculous purulent pleural effusion in adult patients in Yaounde. METHODS We prospectively studied 55 consecutive patients aged 15 years and above, hospitalized in chest clinic of Yaounde Jamot Hospital for non-tuberculous purulent pleural effusion from August 2007 to September 2010. RESULTS Twenty (36.4%) of the 55 patients were HIV-positive and 35 (63.6%) were HIV-negative. The mean age of HIV-positive patients was 37.5±11.7 years compare to 43.2 ±18.5 years on HIV-negative patients (P=0.159). Twelve (60%) HIV-positive patients were females compared to eight (22.6%) of HIV-negative patients (P=0.006). No significant differences were found between the two groups of patients in regard to clinical and radiological features. The mean hemoglobin level was 10.5±2.8g/L in HIV-negative patients and 8.8±2.2g/L in HIV-positive patients (P=0.031). Streptococcus pneumoniae was the most common single bacterial etiology in the two groups with four (50%) cases in HIV-positive and eight (38.1%) cases in HIV-negative. Poor outcome (failure of thoracocenthesis or chest tube drainage and death) was observed in eight (40%) HIV-infected patients and only in four (11.4%) non-infected-HIV patients (P=0.019). CONCLUSION The prevalence of HIV infection among adult patients with non-tuberculous purulent pleural effusion in Yaounde is high. HIV infection does not seem to have any impact on clinical, radiological and bacteriologic characteristics of patients suffering from purulent pleural effusion, but it seems to modify hematologic parameters of these patients. Failure of thoracocenthesis or chest tube drainage was significantly most frequent in HIV-infected patients.