CLINICAL PRESENTATION OF PULMONARY TUBERCULOSIS ASSOCIATED WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME IN METROPOLITAN TOKYO

The clinical features of pulmonary tuberculosis associated with acquir ed immunodeficiency syndrome (AIDS) in Japan were surveyed utilizing q uestionnaires completed by 48 institutes around the Tokyo metropolitan area, We found 11 Japanese and six foreign patients, The average numb er of patients per institute was 0.37. The Japanese patients had advan ced human immunodeficiency virus (HIV) infection, A middle aged man, w ith fever and cough, nonspecific chest X-ray infiltrates, decreased ly mphocyte counts, and a negative tuberculin skin test was the typical p resentation of the Japanese patients, The clinical diagnosis was often difficult. The smear positive rate was high among those from whom sme ars were obtained, suggesting high communicability. None of the isolat es indicated multidrug-resistant tuberculosis at the time of diagnosis , In conclusion, sputum smear and culture remain the keys to diagnosin g tuberculosis in patients with AIDS, although the clinical picture ma y be atypical for pulmonary tuberculosis.