Chest radiograph interpretation of Pneumocystis carinii pneumonia, bacterial pneumonia, and pulmonary tuberculosis in HIV-Positive patients: Accuracy, distinguishing features, and mimics

Phillip M. Boiselle, Irena Tocino, Regina J. Hooley, Andrew S. Pumerantz, Peter A. Selwyn, Vladimir P. Neklesa, Robert C. Lange

Research output: Contribution to journalArticle

60 Scopus citations


The purpose of this study was to assess the accuracy of chest x-ray (CXR) interpretation in the diagnosis of Pneumocystis carinii pneumonia (PCP), bacterial pneumonia (BP), and pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV)-positive patients and to identify the frequency with which these infections mimic one another radiographically. The admitting CXRs of 153 HIV-positive patients with laboratory proven BP (n = 71), PCP (n = 73), and TB (n = 9) and those of 10 HIV-positive patients with no active disease were reviewed retrospectively and independently by three radiologists who were blinded to clinical and laboratory data. Median percent accuracies were as follows: TB, 84%; PCP, 75%; BP, 64%; and no active disease, 100%. Fifteen of 153 cases (9.8%) were shown to mimic other infections radiographically. A confident and accurate diagnosis can be made radiographically in the majority of cases of PCP, BP, and TB in HIV-positive patients at the time of hospitalization. In approximately 10% of cases, these infections may mimic one another radiographically.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalJournal of Thoracic Imaging
Issue number1
StatePublished - Jan 1997



  • Acquired immunodeficiency syndrome (AIDS)
  • Bacterial pneumonia
  • Lung, infections
  • Pneumocystis carinii pneumonia
  • Pulmonary tuberculosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

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