Vol. 13, 1994 313 9. Kahn RI, McAninch JW: Granulomatous disease of the testis. Journal of Urology 1980, 123: 868--871. 10. Wallace RJ, Steele LC, Sumter G, Smith JM: An- timicrobial susceptibility patterns of Nocardia asteroides. Antimicrobial Agents and Chemotherapy 1988, 32: 1776-1779. 11. Wallace RJ, Brown B, Tsukamura M, Brown J, Onyi G: Clinical and laboratory features of Nocardia nova. Journal of Clinical Microbiology1991, 29: 2407-2411. 12. Young LS, Armstrong D, Blevins A, Lieberman P: Nocardia asteroides infection complicating neoplastic disease. American Journal of Medicine 1971, 50: 356- 367. 13. Geelhoed GW, Myers GH: Nocardiosis of the testis. Journal of Urology 1974, 111: 791-793. 14. Strong DW, l-lodges CV: Disseminated nocardiosis presenting as testicularabscess.Urology1976,1: 57-59. 15. Wheeler JS, Culkin DJ, O'Connell J, Winters G: No- cardia epididymo-orchitis in an immunosuppressed patient. Journal of Urology 1986, 136: 1314-1315. 16. Adams HG, Beeler BA, Wann LS, Chin CK, Brooks GF: Synergistic action of trimethoprim and sup famethoxazole for Nocardia asteroides: efficacious therapy in fivepatients. AmericanJournal of Medicine 1984, 287: 8-12. 17. Dewsnup SH, Wright DB: In vitro susceptibility of Nocardia asteroides to 25 antimicrobial agents. An- timicrobia[ Agents and Chemotherapy 1984, 25: 165- 167. 18. Gmnbert ME, Aulidno TM: Synergismof imipenem and amikacin in combination with other antibiotics against Nocardia asteroides. AntimicrobialAgents and Chemotherapy 1987, 24: 810-811. 19. Geiseler PJ, Andersen BR: Results of therapy in sys- temic nocardiosis. American Journal of Medical Science 1979, 278: 188-194. Bordetella pertussis as a Cause of Chronic Respiratory Infection in an AIDS Patient R. Colebundersl*, C. Vael 2, K. Blot 1, J. Van Meerbeeck 3, J. Van den Ende 2, M. Ieven 2 A 60-year.old heterosexual man with AIDS was admitted to hospital with dyspnea, a severe paroxysmal non-productive cough of two months' duration, low-grade fever and exhaustion. Bor- detella pertussis was cultured from a broncho- 1 Department of Medicine, Institute of Tropical Medicine, 2Nationalestraat 155, 2000 Antwe~, Belgium. ~epartmen t of Microbiology and Department of Pulmo- nary Medicine,UniversityHospitalof Antwerp, Edegem, Belgium. alveolar lavage specimen. After erythromycin therapy (500 mg q.i.d, for two weeks) all respira- tory symptoms resolved progressively over a four- week period. Bordetella pertassis should be added to the long list of pathogens that may cause respiratory disease in persons with HIV infection. Bordetella pertussis infection has been described in both adults (1, 2) and children infected with the human immunodeficiency virus (HIV) (3, 4). However, in only three patients was sufficient clinical information available to prove a causal re- lationship between Bordetella pertussis infection and respiratory symptoms (1-3). In two other patients a causal relationship was strongly sug- gested because no other etiologic agent was iden- tified and patients responded clinically to ery- thromycin therapy (1, 2). In three children with HIV infection and pulmonary infiltrates, Bor- detella pertussis was detected intracellularly in macrophages in broncho-alveolar lavage fluid (4). All children had received at least one injec- tion of diphtheria-tetanus-pertussis-vaccine. How- ever, none of the cultures of specimens from these children grew Bordetella pertussis. We describe another case of Bordetella pertussis infection in an adult AIDS patient. This case re- port suggests that Bordetella pertussis may cause chronic respiratory illness in HIV infected adults. Case Report. In April 1991, a 60-year-old hetero- sexual man with AIDS was admitted to the Uni- versity Hospital of Antwerp with dyspnea, severe paroxysmal non-productive cough of two months' duration, low-grade fever and exhaustion (due to the cough). His medical history included diagno- sis of HIV infection in 1988, candida oesophagitis and cytomegalovirus ulceration of the oeso- phagus in 1989. At the time of admission he was receiving zidovudine and Pneumocystis carinii prophylaxis with aerosolized pentamidine. Clini- cal examination on admission revealed extensive psoriasis lesions which appeared after he ac- quired the HIV infection. Chest X-ray and CT scan of the chest were normal. Laboratory tests on admission showed anaemia (haemoglobin 10.6 g/dl), leucopenia (2100/mm 3) with a low CD4 lymphocyte count (17/mm 3) and thrombopenia (76,000/mm3). Abnormal results of liver tests included LDH 410 U/I (normal range 120-240 U/I), ASAT 46 U/I (normal range 2-18 U/I), ALAT 38 U/I (normal range 5-22 U/I), alkaline phosphatase 219 U/I (normal range 61- 157 U/I) and GT 114 U/I (normal range 4-25 U/I).