Sinus infections

You probably hear a lot about sinuses, especially during allergy season. But what exactly are they? Sinuses are empty spaces in bones located at the front of your skull. They are responsible for warming air as you breathe it in.

Sinuses also keep bacteria and germs that you breathe in through your nose from getting into your lungs and the rest of your body. So, sinuses are one of the first lines of defense in the respiratory system. This also makes them a common site of infection among people with HIV with weakened immune systems.

Symptoms of Sinus Infections
Some sinus infections only last up to 4 weeks. This type of sinus infection is described as acute. Acute sinus infections are usually caused by a bacterial infection. Sometimes, a sinus infection can stick around for 12 weeks or longer and even last for years! These types of sinus infections are described as chronic. Chronic sinus infections are usually caused by an allergy. Whether a sinus infection is acute or chronic, the symptoms are the same:

• Nasal congestion
• Headache
• Fever
• Runny nose
• Tightness in the face
• Tenderness or pain in the cheeks and forehead
• Thick mucus that tastes bad

Treating a Sinus Infection
Sinus infections can be extremely painful and can make you feel awful. While you may not feel so swift, treating a sinus infection can be relatively easy. Nonetheless, if you are HIV+, it is very important to see your healthcare provider about any and all infections. Some untreated sinus infections can develop into bacterial pneumonia or bronchitis. Here is a brief description of a 3-step approach that you and your healthcare provider can use to put you on the road to feeling better:

• Antibiotics—a prescription from your healthcare provider for the right antibiotic can help your body get rid of the bacteria causing the infection


• Nasal sprays—talk to your healthcare provider about corticosteroid sprays. These sprays can help shrink the swelling in your sinuses and get rid of some of the pain


• Saltwater nasal washes—this requires you to inhale some salt water through your nose from a cup and then sneeze it back out again. Sound painful? Well, it definitely can be, but these nasal washes can get out the extra mucus from your sinuses. One word of caution: don't do this on your own, and be sure to ask your healthcare provider first for the correct amounts of salt and water to use in your nasal wash

Pneumonia

Pneumonia is an illness that affects the lungs. Pneumonia occurs when air-filled sacs in the lungs responsible for absorbing the oxygen that you breathe become swollen and fill up with liquid.

Pneumonia can be caused by germs, like viruses and bacteria, exposure to certain types of chemicals, or an injury to the lungs. It can also be caused by other illnesses, such as lung cancer or alcohol abuse. In people with HIV, the 2 types of pneumonia most commonly seen are caused by a type of fungus or bacteria:

• Bacterial pneumonia
• Pneumocystis jirovecii pneumonia (PCP)

Bacterial Pneumonia
Bacterial pneumonia is caused by—you guessed it—bacteria. This type of pneumonia usually develops quickly in a few days. The symptoms of bacterial pneumonia are:

• Fever
• Chest pain
• Shortness of breath
• Green or yellowish mucus

People with HIV who use injectable drugs are more likely to get bacterial pneumonia. If you believe that you have bacterial pneumonia, it is important that you contact your healthcare provider right away to get the treatment you need!

Treating and Preventing Bacterial Pneumonia
Bacterial pneumonia is usually treated with antibiotics. Treatment with these types of drugs usually results in a full recovery. You can also take action to prevent bacterial pneumonia. Talk to your healthcare provider about a vaccine that can reduce your risk of getting bacterial pneumonia.

Pneumocystis jirovecii pneumonia
Pneumocystis jirovecii pneumonia, or PCP, is a type of pneumonia caused by a fungus. This condition is only seen in people with weakened immune systems. PCP develops more slowly than bacterial pneumonia but is much more serious. PCP is most commonly seen in people with HIV with CD4 cell counts below 200 and in those who have had PCP in the past. Early treatment offers you the best chance of a full recovery. If left untreated, this type of pneumonia can cause the respiratory system to stop working and eventually cause death. This is yet another reason why getting tested and knowing your status is so important. While PCP is uncommon, it is still one of the major causes of death among people with HIV/AIDS. The symptoms of PCP include:

• Fatigue
• Shortness of breath
• Rapid breathing
• Dry cough
• Fever
• Chills
• Night sweats
• Weight loss

If you believe that you may have PCP, it is very important that you contact your healthcare provider immediately! Your healthcare provider may request a chest x-ray and a mucus sample in order to get an accurate diagnosis.

Treating and Preventing PCP
While PCP is a very serious illness, the good news is there are things that you can do to prevent and treat the disease. There is no vaccine for PCP, but there are special types of combination antibiotics that can be used to both prevent and treat PCP. If your CD4 cell count goes below 200, your healthcare provider will probably recommend that you begin taking these antibiotics to prevent getting PCP. These antibiotics can cause a number of side effects, such as rash, nausea, and others. If you have side effects to the drug, contact your healthcare provider immediately! It is very important to take and finish all of your medication exactly as directed unless your healthcare provider tells you otherwise.

Tuberculosis

Tuberculosis, or TB, is an illness that is caused by certain a certain type of bacteria. These bacteria usually infect the lungs, but they can also get into your bloodstream and infect almost any part of your body, including your liver, kidneys, stomach, bones, skin, breasts, brain, and spinal cord.

Symptoms of Tuberculosis
TB can be spread when a person with active tuberculosis sneezes, coughs, or spits. The tiny drops of liquid from an infected person can spray into the air and carry the bacteria to another person. If you are HIV+, your weakened immune system can increase your risks of infection. The symptoms of TB include:

• A cough that lasts for longer than 2 weeks
• Chest pains
• Coughing up fluid, sometimes with blood

If you have any of these symptoms, it is important to contact your healthcare provider immediately!

Treating Tuberculosis
If you are HIV+ and find out that you have TB, the good news is the treatment options available today are very effective. Like HIV, the bacteria that cause TB can be resistant to certain types of drugs. For this reason, treatment for TB usually begins with a combination of 4 drugs. While you are taking these drugs, your healthcare provider will conduct a lab test to determine if the TB in your body is resistant to any of these drugs. Depending on the test results, you may be able to take fewer medications.

Treatment for TB usually lasts for about 6 months, and symptoms usually get better within 3 to 4 weeks. It is very important that you take and finish all your medicine as instructed by your healthcare provider, even if your symptoms get better. Not doing so can result in serious health problems and can make your TB even worse! One TB medication may increase the risk of developing peripheral neuropathy, a condition that causes tingling in your hands and feet. Talk to your healthcare provider to find out if you are taking this drug. If you are, you should also talk to your healthcare provider about taking vitamin B6 to reduce your risk of developing peripheral neuropathy.