RAPID CLINICAL-DIAGNOSIS OF PULMONARY ABNORMALITIES IN HIV-SEROPOSITIVE PATIENTS BY AUSCULTATORY PERCUSSION

A prospective, blinded study of pulmonary findings in hospitalized pat ients with HIV infection compared auscultatory percussion (AusP) with conventional percussion (ConP) and conventional auscultation (ConA) us ing chest radiographs as the gold standard. Sixty-three patients had c hest radiographs and were examined by one to three examiners. Seventy of the 126 lungs had radiographic abnormalities (55.6 percent). Auscul tatory percussion proved to be the most sensitive of all techniques fo r each examiner (range, 51.0 to 69.6 percent) for detecting radiograph ic abnormalities and also had higher likelihood ratios for two of the three examiners; AusP also had the highest likelihood ratio pooled acr oss examiners. Of the 166 abnormal results of lung examinations, the c ombination of AusP and ConA detected 31 more abnormalities than ConP a nd ConA combined, with 14 of these being diagnosed with Pneumocystis c arinii pneumonia. No abnormalities were detected by ConP that were not detected by AusP. These findings suggest that AusP, a rapid clinical maneuver, is more sensitive and specific than ConA and ConP in determi ning pulmonary abnormalities in HIV-infected inpatients.