Chest
Clinical InvestigationsMycobacterium avium Complex Infection in Patients with the Acquired Immunodeficiency Syndrome: A Clinicopathologic Study
Section snippets
MATERIAL AND METHODS
The autopsy records of all patients reported in the UCLA Medical Center Autopsy Registry to have died with AIDS between November 1981 and January 1986 were reviewed. Of the patients thus identified, 68 fulfilled the criteria for the diagnosis of AIDS established by the Centers for Disease Control10 and were included in the study. The abnormal gross findings and the pathologists formulation of the cause of death were recorded.
For each case, sections of lung, lymph nodes, spleen, adrenal, and
Autopsy Findings
In 24 of the 32 patients with MAC isolated at autopsy, the organism was also demonstrated by microscopic examination of autopsy tissue. In the remaining eight, MAC was detected by culture only. The organism was isolated from the spleen in all cases, and in nine, the spleen was the only culture-positive organ. MAC was isolated from lung tissue in 11 patients. Table 1 shows the sites of microscopically demonstrated involvement. Acid-fast bacilli were observed in one site in five patients (16
DISCUSSION
Despite the high frequency of MAC infection in patients with AIDS, the specific clinical features and contribution to morbidity and mortality have been difficult to define.6,14 In an effort to elucidate these issues, we correlated the autopsy findings and antemortem clinical data from a postmortem population of AIDS patients. The clinicopathologic data obtained suggest that there are specific predisposing factors and clinical characteristics associated with MAC infection.
Although a variety of
ACKNOWLEDGMENTS
The authors thank Dr. I. Jeffry Strumpf for his help in obtaining clinical information on the patients treated in the Southern California Kaiser Permanente system.
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Presented in part at the Annual Meeting, American Thoracic Society, May 12, 1985, Anaheim, Calif.