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[Opportunistic infections in AIDS. The pulmonary manifestations]
1U.O. di Radiodiagnostica, USL C5 Centro S. Chiara, Largo Medaglie d'Oro, Trento.
Abstract:
The initial and follow-up chest radiographs of 31 patients with the acquired immunodeficiency syndrome (AIDS) were reviewed to assess the spectrum and frequency of opportunistic pulmonary infections. In our series, the most common pulmonary infections seen on chest films were: Pneumocystis carinii pneumonia (PCP) (n = 17), PCP associated with Cytomegalovirus (CMV) (n = 2), PCP associated with Mycobacterium avium-intracellulare (MAI) (n = 1), Mycobacterium tuberculosis (n = 7), CMV (n = 2), MAI (n = 1) and Cryptococcus neoformans (n = 1). Diffuse or focal interstitial infiltrate is the most common finding in PCP; bilateral focal or multilobar interstitial infiltrates are also frequently observed: they are usually caused by PCP or by PCP associated with CMV. Infiltrating cavitating lesions and multiple interstitial well-defined nodules < 10 mm diameter were seen only in Mycobacterium tuberculosis infections. Normal chest findings and/or pleural effusions were uncommon; no case exhibited pulmonary cysts on initial radiographs. In this retrospective study we emphasize the high incidence of Mycobacterium tuberculosis infections; other pulmonary infections are emerging in AIDS. The X-ray patterns of pulmonary infections in AIDS must be known for a prompt and accurate diagnosis and to plan the appropriate treatment.
Insights
Chest X-rays reveal common pulmonary infections in AIDS patients, including Pneumocystis pneumonia and Mycobacterium tuberculosis. Understanding these patterns is crucial for timely diagnosis and treatment of opportunistic infections in acquired immunodeficiency syndrome.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Pulmonology
Background:
- Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to opportunistic pulmonary infections.
- Radiographic patterns of these infections can vary significantly.
Purpose of the Study:
- To review chest radiographs of AIDS patients to determine the spectrum and frequency of opportunistic pulmonary infections.
- To correlate radiographic findings with specific pathogens.
Main Methods:
- Retrospective review of initial and follow-up chest radiographs from 31 AIDS patients.
- Analysis of identified pulmonary infections and their radiographic manifestations.
Main Results:
- The most common infections identified were Pneumocystis carinii pneumonia (PCP) (n=17), Mycobacterium tuberculosis (n=7), and Cytomegalovirus (CMV) (n=2).
- Diffuse or focal interstitial infiltrates were common in PCP, often associated with CMV.
- Infiltrating cavitating lesions and nodules were specific to Mycobacterium tuberculosis infections.
Conclusions:
- Chest radiography plays a vital role in diagnosing pulmonary infections in AIDS patients.
- While PCP is common, Mycobacterium tuberculosis is also a significant pathogen, and other infections are emerging.
- Familiarity with diverse radiographic patterns is essential for prompt diagnosis and treatment planning.