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Boiselle Phillip M. M.D.; Tocino, Irena M.D.; Hooley, Regina J. M.D.; Pumerantz, Andrew S. D.O.; Selwyn, Peter A. M.D., M.P.H.; Neklesa, Vladimir P. M.D.; Lange, Robert C. Ph.D.
Journal of Thoracic Imaging: January 1997
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The purpose of this study was to assess the accuracy of chest x-ray (CXR) interpretation in the diagnosis of Pneumocystis carinii pneumonia (PCP), bacterial pneumonia (BP), and pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV)-positive patients and to identify the frequency with which these infections mimic one another radiographically. The admitting CXRs of 153 HIV-positive patients with laboratory proven BP (n = 71), PCP (n = 73), and TB (n = 9) and those of 10 HIV-positive patients with no active disease were reviewed retrospectively and independently by three radiologists who were blinded to clinical and laboratory data. Median percent accuracies were as follows: TB, 84%; PCP, 75%; BP, 64%; and no active disease, 100%. Fifteen of 153 cases (9.8%) were shown to mimic other infections radiographically. A confident and accurate diagnosis can be made radiographically in the majority of cases of PCP, BP, and TB in HIV-positive patients at the time of hospitalization. In approximately 10% of cases, these infections may mimic one another radiographically.

© Williams & Wilkins 1997. All Rights Reserved.