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[Mycobacterial lung infection in 8 patients with AIDS: clinical and radiological features]
A Kawana1, E Toyota, N Kobayashi
1Division of Pulmonology, International Medical Center of Japan.
Abstract:
The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.
Insights
Mycobacterial infections in AIDS patients present with non-specific symptoms and atypical radiographic findings. Early recognition of these features is crucial for timely diagnosis and treatment of AIDS-associated mycobacterial disease.
Area of Science:
- Infectious Diseases
- Immunology
- Radiology
Background:
- The prevalence of mycobacterial infections in patients with Acquired Immunodeficiency Syndrome (AIDS) has been increasing.
- This study focuses on the clinical and radiological characteristics of mycobacterial disease in AIDS patients in Japan.
Observation:
- Eight AIDS patients with mycobacterial disease (6 with Mycobacterium tuberculosis, 2 with Mycobacterium kansasii) were analyzed.
- Patients presented with non-specific symptoms like cough and fever.
- Radiographic findings included lymphadenopathy, miliary shadows, obstructive pneumonia (M. tuberculosis), and multiple infiltrations (M. kansasii).
Findings:
- Median CD4 counts were 75.5/microliter for M. tuberculosis and 21.5/microliter for M. kansasii.
- Most M. tuberculosis isolates showed no drug resistance, except for one with moderate streptomycin resistance.
- AIDS-associated mycobacterial disease can exhibit atypical clinical and radiological features, particularly in advanced stages.
Implications:
- Recognizing the unique clinical and radiological features of mycobacterial diseases in AIDS patients is essential.
- This understanding can aid in earlier diagnosis and improved management of these opportunistic infections.
- Further research into atypical presentations is warranted to improve patient outcomes.