Pleural tuberculosis in patients with and without AIDS.
We retrospectively reviewed the records of 71 patients to determine the epidemiologic and clinical features of pleural tuberculosis in patients with and without AIDS and compared the composition of pleural fluid in these two groups of patients. By age, race, sex, and country of birth, the 21 AIDS and 50 non-AIDS patients with pleural tuberculosis were comparable. However, the AIDS patients were more likely to be intravenous drug abusers than the non-AIDS patients (15/21 vs 6/50, p less than .001). The clinical presentation of each group was similar except that the AIDS patients were more likely to present without respiratory symptoms (4/21 vs 0/50, p less than .001). Pleural fluid and pleural biopsy analyses were not different in the two groups. However, AIDS patients had significantly more chest roentgenographic infiltrates (10/21 vs 11/50, p less than .05), hilar/mediastinal adenopathy (4/21 vs 1/51, p less than .007) and a higher prevalence of bilateral effusions (6/21 vs 5/50, p less than 0.05). AIDS patients were also more likely to have sputum smear/culture positive (10/19 vs 9/49, p less than .001) for mycobacteria. The yield for acid-fast bacilli culture of pleural fluid was higher than previously reported (60%) regardless of AIDS status. Thus, AIDS patients with pleural tuberculosis may present without respiratory symptoms, but otherwise do not differ clinically and epidemiologically from non-AIDS patients. Radiologic and mycobacterial data suggest that pleural tuberculosis in AIDS patients is often part of disseminated mycobacterial infection.
Ankobiah
W A
WA
Division of Pulmonary Medicine, State University of New York, Brooklyn 11203.
Finch
P
P
Powell
S
S
Heurich
A
A
Shivaram
I
I
Kamholz
S L
SL
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D000328:Adult; D001706:Biopsy; D001826:Body Fluids / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D010994:Pleura / Q000473:pathology; D011859:Radiography; D012189:Retrospective Studies; D014396:Tuberculosis, Pleural / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism / Q000382:microbiology / Q000473:pathology