%0 Journal Article %A Kavita Mody %A Mandar Kubal %A Ravindra Nath Sahay %A Amita Athavale %T Smear negative pulmonary tuberculosis in HIV: Over diagnosed or under investigated %D 2012 %J European Respiratory Journal %P P2629 %V 40 %N Suppl 56 %X Introduction: A significant proportion of HIV infected individuals with respiratory complaints and abnormal chest radiograph are labelled as tuberculosis and started empirical treatment without detailed investigations.Aims: The aim of the study was to verify the empirical diagnosis of smear negative pulmonary tuberculosis in HIV infected individuals using diagnostic modalities available at a tertiary medical center in resource limited settings.Methods: 50 HIV infected individuals with respiratory complaints, an abnormal chest radiograoh, and negative sputum for AFB and labelled smear negative pulmonary tuberculosis underwent detailed history, physical examination, and a series of microbiological investigations. HRCT scans of the chest were performed to verify the chest x-ray findings. In the absence of definitive diagnosis on the initial smears, the patients underwent bronchoscopy and sampling of respiratory secretions from the affected areas.Results: Out of the fifty patients enrolled in the study, definitive diagnosis was reached in 47 patients of which 14 patients (28%) had bronchiectasis, 13 patients (26%) had Pneumocystis jiroveci pneumonia, 5 patients (10%) bacterial pneumonia, and 8 patients (16%) had fungal pneumonia. 6 patients (12%) had non infective conditions like cardiomyopathy (3 patients), bronchial asthma (1 patient), non small cell carcinoma (1 patient), and interstitial lund disease (1 patient). Only 1 patient was confirmed to have tuberculosis on sputum AFB culture and also on bronchial washings AFB smears.Conclusion: A wide variety of respiratory conditions other then tuberculosis can be definitively diagnosed in HIV infected individuals if investigated in detail. %U https://erj.ersjournals.com/content/erj/40/Suppl_56/P2629.full.pdf