RADIOGRAPHIC FINDINGS IN PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME, PULMONARY INFECTION, AND MICROBIOLOGIC EVIDENCE OF MYCOBACTERIUM-XENOPI

The authors studied radiographs and clinical histories of 29 patients with acquired immunodeficiency syndrome, symptoms of pulmonary infecti on, and simultaneous microbiologic evidence of Mycobacterium xenopi in the respiratory tract. The presence, nature, and distribution of radi ographic abnormalities were determined and analyzed in accord with cli nical information. In 26 (90%) patients, M. xenopi was the only microo rganism that could be isolated. Chest radiographs were normal in 13 pa tients (45%) and abnormal in 16 patients (55%). Radiographic abnormali ties were bilateral in 94% of cases and predominantly involved the low er lobes. Patchy peribronchial opacities (44%) and miliary nodules (24 %) were the most common abnormalities. Reticular opacities and parench ymal consolidation were seen in 12% of patients. Pleural effusion was seen in 18% of patients. No patients had cavitations or adenopathy. Th ere was no statistically significant difference regarding the mean age (38.7 +/- 7.3 years vs. 40.2 +/- 11.0 years), the duration of clinica lly evident human immunodeficiency virus infection (2.7 +/- 1.2 years vs. 2.8 +/- 1.4 years), and the mean of CD4 cell counts (50.6 +/- 15.3 cells/ml vs. 47.4 +/- 15.9 cells/ml) between the patients with and wi thout abnormalities on chest radiographs. In patients with acquired im munodeficiency syndrome, pulmonary infection, and simultaneous microbi ologic evidence of M. xenopi, chest radiographs can be normal in a sub stantial number of cases. When radiographic abnormalities are present, they differ from those seen in patient not infected with the human im munodeficiency virus who had pulmonary infection caused by M. xenopi a nd from patients with acquired immunodeficiency syndrome and pulmonary infection with nontuberculous mycobacteria other than M. xenopi. Alth ough these findings are not specific, they may be of importance in the imaging of patients with acquired immunodeficiency syndrome, notably in areas where M. xenopi is endemic.