Radiographic features of pulmonary tuberculosis among HIV patients in Maiduguri, Nigeria

Background: Tuberculosis infection may develop at any stage of HIV infection. Pulmonary tuberculosis produces a broad spectrum of radiographic abnormalities among HIV patients. Method:A cross-sectional study of the radiographic features of pulmonary tuberculosis in 60 consecutive confirmed HIV-seropositive patients aged between 18 and 55 years (Mean ± SD: 33.9 ± 8.42) comprising of 34 males and 26 females. Chest x-rays were evaluated for the presence of apical opacities with or without cavitation (typical) or miliary, lower or mid-zone and reticulonodular opacities, pleural effusion, hilar adenopathy and normal radiograph (atypical). Results:The commonest clinical manifestation was productive cough (100%). Oral thrush (87%), weight loss (83%), night sweats (78%), fever (75%), chest pain (50%) and herpes zoster (5%) also occurred in the patients. Normal radiographs constitute the commonest radiographic finding and were seen in 15 (25%) patients. Hilar adenopathy was noted in 5 (8%) patients. Pleural effusion was seen in 10 (16.7%) patients (mean 194.5 ± 82.9/μl). Lower/mid-zone and reticulonodular opacities occurred in 7 (11.6%) and 2 (3%) patients respectively. Conclusion: Majority of patients in our study had normal chest radiographs. Absence of changes in chest radiographs should not exclude the diagnosis of PTB