Chest X-Ray Findings of Acquired Immunodeficiency Syndromes (Aids)

Chest radiographs of 10 AIDS patients (5 homosexuals, 3 bisexuals and 2 hemophiliacs, mean age 40.5 years) were carefully analyzed by qualified radiologists and clinical chest specialists. For easy classification, the radiographic appearances were divided into 4 groups as 1) bilateral perihilar reticulonodular infiltrations (6/10), 3 of which developed diffuse air-space consolidation, 2) focal reticulonodular infiltration (1/10), 3) a patch of soft tissue density with undefined margin (2/10), and 4) bilateral diffuse miliary lesions (1/10). The causes of pulmonary disorders were: 1) Pneumocystis carinii pneumonia (PCP) associated with Cytomegalovirus (CMV) infection (n=2), 2) PCP alone (n=1), 3) CMV alone (n=2), 4) Mycobacterium tuberculosis (TB) infection .(n=2), 5) aspergillosis (n=1). 6) CMV that occurred asynchronously following the treatment for TB (n=1), and 7) uncertain factors (n=2). PCP plus CMV infection and PCP alone manifested as bilateral perihilar reticulonodular infiltrations in the earlier days, followed by progression into alveolar pattern as the disease advanced. There were two CMV infections: one showed no definite lesion on the CXR and the other showed focal reticulonodular infiltrations over the right middle and left upper lung fields[1]. The two TB infections presented differently: one showed bilateral miliary lesions while the other had an upper lobe patch density with ill-defined margin. Finally, the aspergillosis infection took the appearance of a patchy density found in the lingular lobe without apparent cavity formation. Among these limited number of cases we noted that PCP and CMV were common microorganisms afflicting the lungs of AIDS patients in our country. Also notably, TB seemed to play a significant role in the pulmonary disorder of these immunocompromised patients. In none of our 10 patients was Kaposi sarcoma (KS) found.