Abdominal computed tomographic findings of Mycobacterium tuberculosis and Mycobacterium avium intracellulare infection in HIV seropositive patients.
OBJECTIVE
To compare the computed tomographic (CT) findings of abdominal Mycobacterium tuberculosis (MTB) infection and Mycobacterium avium intracellulare (MAI) infection in patients with human immunodeficiency virus (HIV) infection.


METHODS
A retrospective review of the CT findings of 30 patients with HIV and proven MTB (n = 9) or MAI (n = 21) infection was conducted. Images were reviewed by a radiologist blinded to the diagnosis, and the radiologic findings involving the abdominal viscera, peritoneum and lymph nodes were compared.


RESULTS
The following were more frequent in patients with MAI infection: hepatomegaly (MAI 71% v. MTB 44%, p < 0.05), uniform attenuation of lymph nodes (MAI 90% v. MTB 55%, p < 0.05) and clustered pattern of lymph nodes (MAI 57% v. MTB 22%, p < 0.05). In patients with MTB infection, lymph nodes with low attenuation centrally were more common (MAI 10% v. MTB 44%, p < 0.05), and mesenteric lymph nodes were significantly larger (MAI mean = 20 mm v. MTB mean = 40 mm, p < 0.05).


CONCLUSIONS
Although nonspecific, CT may be useful in the early diagnosis of MTB and MAI infection, allowing for presumptive treatment before microbiologic confirmation.
Koh
Dow-Mu M
DM
Chelsea and Westminster Hospital, London, UK.
Burn
Paul R
PR
Mathews
Gail
G
Nelson
Mark
M
Healy
Jeremiah C
JC
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D002432:Cecum / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006679:HIV Seropositivity; D006529:Hepatomegaly / Q000000981:diagnostic imaging; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007668:Kidney / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging*; D010537:Peritoneum / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging; D013163:Splenomegaly / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000000981:diagnostic imaging*; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging