title: Utility of paired blood cultures and smears in diagnosis of disseminated Mycobacterium avium complex infections in AIDS patients.
abstract: For 273 patients evaluated for disseminated Mycobacterium avium complex infection, a total of 1,047 mycobacterial blood cultures (MBCs) were submitted; the M. avium complex was recovered from 140 (13%) of the specimens. Results for the paired MBCs were highly concordant: in 392 of 462 (85%) culture sets, both MBCs were negative, in 53 of 462 (11%) sets, both MBCs were positive, and in only 17 of 462 (4%) sets was one culture positive and the other negative. Acid-fast smears were done on sediments from 671 specimens; smears were positive for 4 of 98 (4%) cultures that grew the M. avium complex. A single MBC should be obtained and then repeated if negative and disseminated M. avium complex infection is still clinically suspected. Use of direct acid-fast smears of sediments is not a reliable means of detecting mycobacteremia.
authors.affiliation: Denver Disease Control Service, Denver Health and Hospital, Colorado 80204.
authors.forename: B L
authors.initials: BL
authors.lastname: Stone
authors.forename: D L
authors.initials: DL
authors.lastname: Cohn
authors.forename: M S
authors.initials: MS
authors.lastname: Kane
authors.forename: M V
authors.initials: MV
authors.lastname: Hildred
authors.forename: M L
authors.initials: ML
authors.lastname: Wilson
authors.forename: R R
authors.initials: RR
authors.lastname: Reves
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D016470:Bacteremia / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques / Q000191:economics; D003365:Costs and Cost Analysis; D003951:Diagnostic Errors; D006801:Humans; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology