Life-threatening bacterial pneumonia in male homosexuals with laboratory features of the acquired immunodeficiency syndrome

Two male homosexuals with laboratory features of the acquired immunodeficiency syndrome developed fulminanting pneumonia requiring mechanical ventilatory support despite antibiotic therapy. Pathology consistent with bacterial pneumonia without other opportunistic pathogens were found at open lung biopsy. Cultures from the open biopsy grew Hemophilus influenzae in one, and Streptococcus pneumoniae was seen on Gram stain and sputum culture prior to antimicrobial treatment in the other. Each recovered on continued single antibiotic therapy. Life-threatening bacterial pneumonia may be a feature of the acquired immunodeficiency syndrome, possibly due to B cell abnormalities.