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  • Title: Chest radiograph interpretation of Pneumocystis carinii pneumonia, bacterial pneumonia, and pulmonary tuberculosis in HIV-positive patients: accuracy, distinguishing features, and mimics.
    Author: Boiselle PM, Tocino I, Hooley RJ, Pumerantz AS, Selwyn PA, Neklesa VP, Lange RC.
    Journal: J Thorac Imaging; 1997 Jan; 12(1):47-53. PubMed ID: 8989759.
    Abstract:
    The purpose of this study was to assess the accuracy of chest x-ray (CXR) interpretation in the diagnosis of pneumocystis carinii pneumonia (PCP), bacterial pneumonia (BP), and pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV)-positive patients and to identify the frequency with which these infections mimic one another radiographically. The admitting CXRs of 153 HIV-positive patients with laboratory proven BP (n = 71), PCP (n = 73), and TB (n = 9) and those of 10 HIV-positive patients with no active disease were reviewed retrospectively and independently by three radiologists who were blinded to clinical and laboratory data. Median percent accuracies were as follows: TB, 84%; PCP, 75%; BP, 64%; and no active disease, 100%. Fifteen of 153 cases (9.8%) were shown to mimic other infections radiographically. A confident and accurate diagnosis can be made radiographically in the majority of cases of PCP, BP, and TB in HIV-positive patients at the time of hospitalization. In approximately 10% of cases, these infections may mimic one another radiographically.
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