Active pulmonary tuberculosis in patients with AIDS: Spectrum of radiographic findings (including a normal appearance)

Stephen D. Greenberg, David Frager, Bernard Suster, Sidney Walker, Christine Stavropoulos, Allen Rothpearl

Research output: Contribution to journalArticlepeer-review

212 Scopus citations

Abstract

PURPOSE: To assess the efficacy of chest radiography in the detection of active pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS). MATERIALS AND METHODS: Initial interpretations of chest radiographs of 133 adult patients with AIDS and positive sputum or bronchoalveolar lavage cultures for Mycobacterium tuberculosis were reviewed. Radiographic findings were correlated with CD4 T-cell counts, sputum stains for acid-fast bacilli (AFB), and antituberculous drug sensitivity. RESULTS: Forty-eight (36%) patients had a primary M tuberculosis pattern, 38 (28%) had a postprimary M tuberculosis pattern, 19 (14%) had normal radiographs, 17 (13%) had atypical infiltrates, seven (5%) had minimal radiographic changes, and four (3%) had a miliary pattern. Normal chest radiographs were seen for 10 (21%) of 48 patients with less than 200 T cells per microliter and one (5%) of 20 patients with more than 200 T cells per microliter. Drug sensitivity and sputum staining for AFB did not correlate with radiographic findings. Overall, 19% of cases had multidrug resistance to antituberculous medications. CONCLUSION: Chest radiographs did not suggest active tuberculosis in 43 (32%) of 133 AIDS patients with active pulmonary tuberculosis.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalRadiology
Volume193
Issue number1
DOIs
StatePublished - Oct 1994
Externally publishedYes

Keywords

  • Acquired immunodeficiency syndrome (AIDS)
  • Tuberculosis, pulmonary

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