Pulmonary Infection in AIDS

Kim, Seog Joon; Im, Jung Gi; Seong, Chang Kyu; Song, Jae Woo; Yeon, Kyung Mo; Han, Man Chung

Abstract

PURPOSE: To analyze the clinical and radiological manifestations of pulmonary infection in patients with AIDS.
MATERIALS AND METHODS
We reviewed the medical records and analyzed retrospectively analysed the chestradiographs (n=24) and CT scans (n=11) of 26 patients with AIDS who had been followed up at our institute from1987 to June 1998. Pulmonary infections were confirmed by sputum smear and culture (n=18), pleuralexamination(n=3), bronchoalveolar lavage (n=3), autopsy (n=4), transbronchial lung biopsy (n=1) or clinicalhistory (n=9). The study group included 23 men and three women aged 25-54 (average 35.2) years. We correlated theradiologic findings with CD4 lymphocyte counts. RESULT: Pulmonary infections included tuberculosis (n=22),Pneumocystis carinii pneumonia (n=9), cytomegalovirus (n=3), and unidentified bacterial pneumonia (n=2).Radiologically pulmonary tuberculosis was classified as primary tuberculosis (n=11 ; mean CD4 counts: 41.3cells/mm3) and post-primary tuberculosis (n=11 ; mean CD4 counts: 251.3 cells/mm3). CT findings of tuberculosisincluded lymphadenitis (n=6), bronchogenic spread (n=5), large consolidation (n=4), esophago-mediastinal fistula(n=2), and cavity (n=1). Tuberculosis in AIDS responded rapidly to anti-TB medication with complete or markedresolution of lesions within three months. Radiologic findings of Pneumocystis carinii pneumonia included diffuseground glass opacities, cysts, and reticular opacities.
CONCLUSION
Tuberculosis was the most common infection inpatients with AIDS in Korea, and this is attributed to the high prevalence of tuberculosis. Radiological findingsvaried with CD4+ cell count, showing those of primary tuberculosis as a patient's CD4+ cell count decreased.Pulmonary tuberculosis in AIDS responded rapidly to anti-Tb medication.