Chest 1999;115 4: For example, the finding of rales in association with a cardiac S3 gallop and elevated jugular venous pressure suggests a cardiac etiology for the respiratory symptoms. The chest radiograph is the cornerstone of the diagnostic evaluation of respiratory symptoms in HIV-infected patients. Am Rev Respir Dis 1989;139 6: In a patient with sudden onset of pleuritic chest pain or shortness of breath, findings of absent breath sounds would be worrisome for pneumothorax.
Each of these OIs and neoplasms has a characteristic clinical and radiographic presentation. An official ATS statement: Pulmonary Kaposi sarcoma characteristically presents with bilateral opacities in a central or perihilar distribution Figure 7 , Figure 8.
Specimens may be examined microscopically or cultured for bacterial, mycobacterial, fungal, viral, and parasitic pathogens, and they may be sent for cytopathologic and pathologic studies.
No clinical symptoms or signs could distinguish patients with pulmonary Kaposi sarcoma from those with pulmonary Kaposi sarcoma and a concurrent pulmonary OI. References 1. This author's firsthand experience indicates that these pneumonias often differ by the presence or absence of purulent sputum and the duration of respiratory symptoms.
Occasionally, additional tests such as chest CT scan, chest high-resolution CT HRCT scan, and pulmonary function tests may be needed to further evaluate the cause of the symptoms and to further refine the differential diagnosis. The OIs involve bacterial, mycobacterial, fungal, viral, and parasitic pathogens.
In cases of suspected PCP, the diagnostic approach usually includes sputum induction or bronchoscopy.
Community-acquired bacterial pneumonia in human immunodeficiency virus-infected patients: July 20, 2015; DOI: Kaposi Sarcoma Pulmonary Kaposi sarcoma characteristically presents with bilateral opacities in a central or perihilar distribution Figure 7 , Figure 8. Researchers collected clinical and radiographic data prospectively and in a standardized fashion and, in subjects who developed new or worsening respiratory symptoms and in whom there was a suspicion of pulmonary disease, pursued definitive microbiologic and pathologic diagnoses whenever possible.
Get information on prevention, symptoms, and treatment to better ensure a long and healthy life. JAMA 1992;267 4: Furthermore, diffuse opacities may result from any severe pulmonary disease.
Clinical manifestations and predictors of disease progression in drug users with human immunodeficiency virus infection [published erratum appears in N Engl J Med 1993;328 9: Unpublished data; 2007. This, in turn, will suggest a diagnostic and therapeutic approach. The initial approach should include sputum, blood, and pleural fluid cultures for bacteria and the use of empiric broad-spectrum antibiotics.
The characteristic chest radiographic presentations of the most common OIs--PCP and bacterial pneumonia--should be familiar to clinicians because of their frequency.