To evaluate roentgenographic severity of CAP in AIDS.
We retrospectively reviewed medical records and chest roentgenograms of 30 consecutive patients with AIDS (17 males, 13 females, age range: 25-63 years; mean age: 44 years) hospitalized with the diagnosis of CAP. Diagnosis of CAP was based on symptoms of cough, sputum production and a chest x-ray showing an infiltrate. All patients underwent sputum Gram-stains and cultures and blood cultures before the initiation of antibiotics.
Twenty-one of 30 (70%) patients presented with an infiltrate involving a single lobe, while 9 (30%) patients had multi-lobar disease (P: .005). Sputum Gram-stains and cultures showed normal flora in all patients. Blood cultures were positive in 6 (20%) patients: Strept Pneumoniae in 4, Klebsiella Pneumoniae in 1, and Staph Aureus in 1. Five of 6 (83%) patients with positive blood cultures had multi-lobar pneumonia and one (5%) patient with single-lobe disease (P: .005).
Majority of AIDS patients with CAP present with single-lobe disease. Multi-lobar pneumonia is predictive of a positive blood culture, which is infrequent in single-lobe disease. Sputum Gram-stains and cultures tend to have little value in etiologic diagnosis of CAP in AIDS.
Blood cultures are useful in the etiologic diagnosis of multilobar pneumonia in AIDS patients.
H. Aziz, None.