Disseminated histoplasmosis in AIDS: Findings on chest radiographs

Dewey Conces, S. M. Stockberger, R. D. Tarver, L. J. Wheat

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS. MATERIALS AND 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. CONCLUSION. 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.

Original languageEnglish (US)
Pages (from-to)15-19
Number of pages5
JournalAmerican Journal of Roentgenology
Volume160
Issue number1
StatePublished - 1993

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Histoplasmosis
Acquired Immunodeficiency Syndrome
Thorax
Pleural Effusion
Lung
Air
Granuloma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Conces, D., Stockberger, S. M., Tarver, R. D., & Wheat, L. J. (1993). Disseminated histoplasmosis in AIDS: Findings on chest radiographs. American Journal of Roentgenology, 160(1), 15-19.

Disseminated histoplasmosis in AIDS : Findings on chest radiographs. / Conces, Dewey; Stockberger, S. M.; Tarver, R. D.; Wheat, L. J.

In: American Journal of Roentgenology, Vol. 160, No. 1, 1993, p. 15-19.

Research output: Contribution to journalArticle

Conces, D, Stockberger, SM, Tarver, RD & Wheat, LJ 1993, 'Disseminated histoplasmosis in AIDS: Findings on chest radiographs', American Journal of Roentgenology, vol. 160, no. 1, pp. 15-19.
Conces, Dewey ; Stockberger, S. M. ; Tarver, R. D. ; Wheat, L. J. / Disseminated histoplasmosis in AIDS : Findings on chest radiographs. In: American Journal of Roentgenology. 1993 ; Vol. 160, No. 1. pp. 15-19.
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abstract = "OBJECTIVE. Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS. MATERIALS AND 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. CONCLUSION. 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.",
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N2 - OBJECTIVE. Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS. MATERIALS AND 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. CONCLUSION. 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.

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