CHEST X-RAYS IN PNEUMONIA BY PNEUMOCYSTIS-CARINII IN AIDS PATIENTS - FORMS OF PRESENTATION AND EVOLUTION

BACKGROUND: We intend to determine the frequency of the different radiographic findings of Pneumocystis carinii pneumonia in patients with AIDS. METHODS: We retrospectively review the chest roentgenograms of 30 patients at admission to the hospital (group I [n = 30]), at follow-up (group II [n = 30]) and after clinical recovery (group III [n = 15]). RESULTS: Diffuse bilateral interstitial disease was the most frequent radiographic finding at admission (76.6 %) and at follow-up (60 %). Atypical radiographic findings were: normal chest radiograph (group I [n = 31), nodules (group I [n = 2], group II [n = 2], group III [n = 1]), thin wall cysts (group II [n = 1], group III [n = 1]), cavitated lesion (group II In = 1], group III [n = 1]), pneumothorax (group II [n = 2], group III [n = 1]), pleural effusion (group III [n = 2]), asymmetrical distribution of the pulmonary lesion (group I [n = 2], group II [n = 3]) and predominant upper lobe involvement (group II [n = 1], group III [n = 1]). The atypical findings were greater during follow-up (group II [n = 33.3 %], group III (46.6 %) than at admission (group I [n = 23.4 %]). CONCLUSIONS: It is important to know the frequency and multiplicity of the radiographic findings of Pneumocystis carinii pneumonia in order to establish the diagnosis and differentiation from other infectious diseases or other causes of pulmonary disease in patients with AIDS.