Resolution of HIV-associated adult lymphocytic interstitial pneumonitis in pregnancy

A histologically proven case of lymphocytic interstitial pneumonia in a HIV infected adult with an undetectable viral load

Lymphocytic interstitial pneumonia (LIP) is on the spectrum of lymphoproliferative diseases that can affect the lungs. Although common in human immunodeficiency virus (HIV) infected children, it is rarely reported in adults. A 51-year-old HIV infected female patient presented with worsening dyspnea over five months. She had radiological findings of bilateral lung nodular infiltrates. Her CD4 count was 835 cells/uL and her HIV viral load was undetectable. Bronchoalveolar lavage did not yield any infectious pathogen. The pathology on an open lung biopsy revealed marked lymphocytic infiltrates and widening of alveolar septa consistent with the diagnosis of LIP. LIP is a rare entity in adults. Previously reported cases in HIV infected adults were associated with a high HIV viral load at the time of diagnosis. Here we present the first case of LIP in an HIV infected adult with an undetectable viral load.

Undiagnosed HIV Presenting with Lymphoid Interstitial Pneumonitis

Undiagnosed or untreated human immunodeficiency virus infection can lead to devastating complications. We present a case of a 41-year-old woman who was found to have HIV-related lymphoid interstitial pneumonitis. LIP is uncommon, and its presentation can be quite similar to that of other chronic lung conditions. This case illustrates one of the possible protean manifestations of untreated HIV and is a sobering reminder of the need to screen all adults for HIV infection. Additionally, further invasive diagnostic testing may be required to guide therapy in patients with advanced acquired immune deficiency syndrome. This patient's LIP was likely related to long-standing unrecognized HIV disease.