Abstract
Diagnosis of TB in patients with HIV infection is often difficult because of the low frequency allocation MBT in the sputum, and not the typical radiographic manifestations.
Material and methods. The study enrolled 52 patients with verified respiratory tuberculosis in the presence of HIV infection and CD4 <200 cells/ul (Atlanta, USA, 1993). Analyzed CT data, identify MBT in sputum and lymph node biopsies.
Results. Only 4 ( 7.69 % ) were detected by microscopy for acid- sticks . In 33 ( 63.46 %) MBT culture identified by PCR in sputum. Identification MBT by PCR of 100% was confirmed by seeding a liquid culture medium ( BACTEC MGIT 960) . In 14 (26.92%) patients by PCR identified MDR MBT. In 14 ( 26.92 %) patients diagnosed with tuberculosis installed biopsy of peripheral or intrathoracic lymph nodes. When analyzing the CT picture only 36 (69%) patients revealed well-defined nodules, typical of tuberculosis. Cavities were observed 19 (36.5%) patients. While 18 (34.6%) in the CT picture dominated interstitial infiltrates and ground-glass nodules. Adenopathy noted in 39 (75%) cases. In 50 (96.2%) patients had a combination of several syndromes CT.
Conclusion. As immunosuppression progresses, the CT pattern of respiratory tuberculosis in the presence of HIV infection shows as atypical syndromes (unclearly defined frosted glass-type focal changes, interstitial infiltrations). A marked polymorphism in changes and a high rate of lymph node involvement are characteristic. Microscopy is not effective to detect MBT in patients with HIV infection and low CD4. For verification of tuberculosis, a broader application of molecular genetic techniques and lymph node biopsies.
- © 2014 ERS
