Establishment of differential diagnosis of pathogen in various pulmonary infections with CT according to host's immunity

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This research was planned to clarify a correlation between the immune states and HRCT findings in variety of pulmonary infections. For this purpose, HRCT was performed in patients with clinical and/or chest X-p suspicion of pulmonary infection of any kind. Within three days of HRCT, peripheral blood sampling was done. Patient's immune state was evaluated by lymphocyte count and subset, CD2/4/8 ratios, NK cell activity, lymphocyte reaction, lgG, lgM, lgA, C3, and C4.Pathogens of pulmonary infection was determined by smear, culture, and PCR of sputum and alveolar lavage, transbronchial biospy, and serum antigen and antibody level.In 68 patients, both HRCT and data of immune state were obtained. Pathogens were as follows : tuberculosis (TBC) : 36, atypical mycobacterium (AM) ; 18, pneumocystis carinii (PC) ; 5, fungus ; 4, bacteria ; 3, and mycoplasma ; 2. In TBC or AM, atypical or wider distrubution of abnormality was observed on HRCT in patients with a decreased cellular immunity. Atypical findings, such as consolidation, miliary nodules, pleural effusion, lymphadenopathy were more commonly seen rather than typical findings including centrilobular nodules, single cavitary nodule, tree in bud appearance that are characteristic in patients with normal immunity.