Ultrasound,guided percutaneous transthoracic needle aspiration biopsy for diagnosis of pulmonary lesions in advanced HIV infection

Pulmonary diseases remain the most common complication associated with high morbidity and mortality in patients with human immunodeficiency virus (HIV ) infection. Invasive diagnostic procedures are often needed to establish a specific diagnosis of pulmonary disease. We report our experience with ult rasound (US) guided percutaneous transthoracic needle aspiration (PTNA) bio psy in 20 consecutive patients with advanced HIV infection who presented wi th a variety of pulmonary lesions with or without pleural effusion. A speci fic diagnosis was established in 16 patients (80%),with infection being the most common etiology. Sputum culture yielded the same causative pathogen i n three patient (15%) and all had more than one bacterial or fungal isolate s. Mild pneumothorax, the only complication, was observed in two patients ( 10%) following the procedure. Neither patient required chest tube drainage. Our findings suggest that US-guided PTNA can be a useful and safe alternat ive to fluoroscopy-guided PTNA in selected HIV-infected patients with focal pulmonary lesions and pleural effusion.