Disseminated histoplasmosis in AIDS: findings on chest radiographs.
OBJECTIVE
Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS.


METHODS
Chest radiographs of 50 AIDS patients with documented extrapulmonary histoplasmosis were analyzed retrospectively. The radiographs were evaluated for the presence of parenchymal opacities, pleural effusions, adenopathy, cavitation, and calcified granulomas and lymph nodes. A modification of the International Labour Office scheme was used to classify parenchymal abnormalities as nodular, linear or irregular, reticulonodular, or air-space opacities.


RESULTS
Abnormalities were present on radiographs in 23 patients. Nodular opacities were present in 10 patients and were diffusely distributed in nine patients. Linear or irregular opacities were present in seven patients, with diffuse distribution in four and limited involvement in three. Air-space opacities were present in seven patients; the distribution varied from segmental to diffuse involvement of the lung. Small pleural effusions were present in five patients. Adenopathy and Kerley's B lines were each present in three patients. In 27 patients, the chest radiographs were normal. Four of these patients had clinical or microbiological evidence of lung involvement.


CONCLUSIONS
The chest radiographic findings of disseminated histoplasmosis in AIDS patients are varied and nonspecific. The presence of diffuse nodular or linear/irregular opacities in an AIDS patient, especially one who resides in or has resided in an endemic area, should suggest the possibility of disseminated histoplasmosis. Normal findings on chest radiographs do not exclude disseminated infection or lung involvement.
Conces
D J
DJ
Department of Radiology, Indiana University School of Medicine, Indianapolis 46202-5253.
Stockberger
S M
SM
Tarver
R D
RD
Wheat
L J
LJ
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006660:Histoplasmosis / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008172:Lung Diseases, Fungal / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies