GA-67 SCINTIGRAPHY IN AIDS-RELATED TUBERC ULOSIS AND M-AVIUM-M-INTRACELLULARE INFECTIONS

BACKGROUND: Diagnosis of mycobacterioses in HIV infected patients is s ometimes difficult because of atypical findings. The aim of this study was to assess the utility of gallium scintigraphy in diagnosis of AID S related mycobacterioses in patients with fever of unknown origin. PA TIENTS AND METHODS: We retrospectively reviewed the scans of 220 HIV ( +) patients with fever (176 males [80%] and 44 females) who were evalu ated with conventional diagnostic procedures at least of a week before . RESULTS: Gallium scintigraphy was positive in 114 patients (51%) and negative in 106 (49%), Mycobacteria were isolated in 83 patients (38% ), 75 of these patients (90%) had a positive scintigraphy (sensitivity 90%; specificity 71%). Positive predictive Value was 66% and negative predictive value was 92%, mycobacterium avium-M, intracellulare (MAI) and M. tuberculosis were diagnosed in 22 (29%) and 53 (71%) HIV ( +) patients, respectively. Seventy one (94%) of 75 patients with mycobact erioses had gallium uptake in at least two localizations. CONCLUSIONS: Ga-67 scintigraphy is very useful in HIV (+) patients with fever of u nknown origin. A negative gallium scintigraphy makes unlikely the diag nosis of mycobacterioses.