Radiological Manifestations in Patients of Pulmonary Tuberculosis with Hiv

Background: Tuberculosis infection is the most common co-infection among Human Immunodeficiency Virus (HIV) sero-positives in high tuberculosis prevalence countries. Radiological presentation of pulmonary tuberculosis (PTB) is variable in both HIV negative and positive patients. But this variability is more in HIV positive patients. Objective: To study radiological manifestations in patients of pulmonary tuberculosis with HIV. Materials and Methods: In this prospective observational study we studied radiological findings of pulmonary tuberculosis cases having HIV infection in Shree M. P. Shah Medical College & Guru Gobind Sing Hospital, Jamnagar, Gujarat from November 2003 to July 2006. Results: There was a higher involvement of lower lung field (41.86%) as compare to upper lung field (23.26%) while 34.88% had extensive disease. Cavitary lesions were more frequently observed in extensive diseases (60%). Incidence of mediastinal lymphadenopathy and pleural effusion was equal in upper lung field while in lower lung field; incidence of mediastinal lymphadenopathy was higher as compare to pleural effusion. Conclusion: In HIV positive patients, pulmonary tuberculosis is more likely to present with atypical radiological images. So, in HIV positive patients, we must consider PTB in all atypical radiological presentation for prompt diagnosis and management. Key message: HIV positive patients presenting with lower lung field lesions even without cavitary lesion, possibility of TB should always be considered.