Disseminated mycobacterial infection in AIDS patients: abdominal US features and value of fine-needle aspiration biopsy of lymph nodes and spleen.
Abdom Imaging
; 28(5): 602-8, 2003.
Article
en En
| MEDLINE
| ID: mdl-14628859
ABSTRACT
BACKGROUND:
We evaluated the efficacy of abdominal ultrasound (US) and fine-needle aspiration biopsy (FNAB) in the diagnosis of disseminated mycobacteriosis (DM) in acquired immunodeficiency syndrome (AIDS).METHODS:
Twelve AIDS patients (nine male, three female; age range, 22-43 years) with DM underwent abdominal US within 2 days after admission with 3.5- to 5-MHz convex probes and a 7.5-MHz linear probe. All patients underwent FNAB of one or two enlarged abdominal lymph nodes. Eight patients underwent FNAB of the spleen. The aspirated specimens were stained with acid fast for quick examination and cultured for isolation of mycobacteria.RESULTS:
Abdominal US showed enlarged, hypoechoic, round or oval, abdominal lymph nodes (diameter, 10-35 mm; mean, 18 mm) in all patients; splenomegaly (spleen diameter, 14-22 cm; mean, 16.8 mm) in all patients; numerous splenic abscesses (diameter, 3-20 mm) in nine patients; hepatomegaly (right hepatic lobe thickness, 14.5-17 cm) in all patients; small intestinal wall thickening in five patients (maximum bowel wall thickness, 7-15 mm); mild to moderate ascites in six patients; pleural effusion in four patients; bilateral enlargement of the kidneys with hyperechogenicity of the cortex in three patients; and a retroperitoneal tubercular abscess in one patient. No complication occurred after FNAB of lymph nodes and spleens. Fast-acid stain of spleen and/or lymph node FNAB specimens allowed early diagnosis of mycobacteriosis in 12 of 12 cases (100%). Cultures of lymph node aspirates grew mycobacteria in six of 12 patients (50%). Spleen aspirates grew mycobacteria in nine of nine patients (100%). Blood cultures were positive in four of 12 patients (33%). Mycobacterium tuberculosis was diagnosed in six patients and M. avium in five.CONCLUSION:
Abdominal US features can suggest DM in AIDS patients. Spleen and/or lymph node FNAB indicated the specific diagnosis in 100% of patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tuberculosis Gastrointestinal
/
Tuberculosis Hepática
/
Tuberculosis Ganglionar
/
Peritonitis Tuberculosa
/
Tuberculosis Esplénica
/
Infección por Mycobacterium avium-intracellulare
/
Infecciones Oportunistas Relacionadas con el SIDA
Tipo de estudio:
Diagnostic_studies
/
Screening_studies
Límite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Abdom Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2003
Tipo del documento:
Article
País de afiliación:
Italia