Productive cough, shortness of breath, and fever are symptoms of tuberculosis and pneumonia caused by certain common types of bacteria; these symptoms may also be caused by PCP, certain viruses, Kaposi’s sarcoma in the lung, and several other unusual conditions.
Bacterial pneumonias-Bacteria have always been a major cause of serious pneumonias. Before penicillin became available in the 1940s, bacterial pneumonias were the most common cause of death in the United States.
The symptoms of bacterial pneumonias are fever, shortness of breath, and a cough that produces thick yellow or green sputum. For some people, the major symptom is chest pain, especially when they breathe. Unlike PCP and TB, bacterial pneumonias usually begin rather abruptly, and people see physicians within days, rather than weeks or months.
Bacterial pneumonias can occur relatively early in the course of HIV infection. Unlike PCP, bacterial pneumonias do not necessarily indicate a severely weakened immune system. One common bacterial pneumonia is caused by a microbe called pneumococcus; people with HIV infection seem especially prone to pneumococcal pneumonia.
The diagnosis of bacterial pneumonias is usually established with a chest x-ray and sputum tests. Treatment with antibiotics is highly effective when begun early in the infection. Furthermore, a vaccine can now help prevent pneumococcal pneumonia.
Trimethoprim-sulfamethoxazole, which prevents PCP, will prevent pneumococcal pneumonia as well. Bacteria other than pneumococcus cause pneumonias as well, but the symptoms, diagnostic tests, and treatment are all similar.