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Roentgenorgraphic Presentation of Community-Acquired Pneumonia (CAP) in AIDS Patients FREE TO VIEW

M. A. Khan, MBBS; Hany Aziz, MD*; Suleiman Momany, MD; Ghassan Wardeh, MD; Amal Al-Shrouf, MD
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St. Joseph’s Regional Medical Center and Seton Hall University, Paterson, NJ


Chest. 2004;126(4_MeetingAbstracts):916S. doi:10.1378/chest.126.4_MeetingAbstracts.916S-b
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PURPOSE:  To evaluate roentgenographic severity of CAP in AIDS.

METHODS:  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.

RESULTS:  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).

CONCLUSION:  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.

CLINICAL IMPLICATIONS:  Blood cultures are useful in the etiologic diagnosis of multilobar pneumonia in AIDS patients.

DISCLOSURE:  H. Aziz, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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