ABSTRACT
We reviewed the medical records and chest radiographs of 23 adult patients with culture-proved tuberculosis and verified acquired immune deficiency syndrome. Seventeen patients, including 8 with disseminated tuberculosis, had positive sputum or bronchial washing cultures for Mycobacterium tuberculosis. Their initial pretreatment radiographs revealed hilar and/or mediastinal adenopathy in 10 patients (59%), localized pulmonary infiltrates limited to the middle or lower lung fields in 5 patients (29%), localized pulmonary infiltrates involving an upper lobe in 3 patients (18%), diffuse miliary or interstitial infiltrates in 3 patients (18%), no pulmonary infiltrates in 6 patients (35%), and no abnormalities in 2 patients (12%). Pulmonary cavitation was not seen. Only 1 patient (6%) had a chest radiograph typical of adult onset reactivation tuberculosis (i.e., localized pulmonary infiltrate involving the upper lung fields without hilar or mediastinal adenopathy). Six patients (35%) had pulmonary infiltrates that may have been caused by concomitant nontuberculous infection. Six patients had positive cultures for M. tuberculosis from extrapulmonary sites only. Three (50%) of these patients had hilar and/or mediastinal adenopathy. None of them had pulmonary infiltrates on their initial chest radiograph.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnosis , Tuberculosis/diagnostic imaging , Acquired Immunodeficiency Syndrome/complications , Adult , Female , Humans , Male , Mediastinum/diagnostic imaging , Middle Aged , Radiography , Tuberculosis/complicationsABSTRACT
Seventeen patients with pathologically proven intrahepatic abscesses seen over a 12 month period were retrospectively evaluated. Of these 17 patients, 16 had at least three of the four commonly used imaging techniques for the evaluation of hepatic abscesses, including scintigraphy with technetium-99m-labeled sulfur colloid and gallium-67 citrate, sonography, and computed tomography. Of the 17 abscesses, 12 were of pyogenic and five were of amebic origin. Technetium-99m sulfur colloid correctly identified 14 of 16 abscesses; gallium, nine of 10; sonography, 12 of 16; and computed tomography, 15 of 17. The rational approach to the diagnosis of intrahepatic abscesses should be a 99mTc sulfur colloid scan followed, if necessary, by either sonography or CT. In equivocal cases a gallium scan may be of value.
