Opportunistic infections in adults with acquired immunodeficiency syndrome: a comparison of clinical and autopsy findings

Many opportunistic infections causing death in acquired immunodeficiency syndrome (AIDS) patients are often not diagnosed prior to death. The objective of this study was to compare the premortem and postmortem diagnoses of opportunistic infections and tumors among 15 AIDS patients treated in a hospital in southern Taiwan. Total autopsy (brain, chest and abdominal cavity) was performed in 2 patients, and partial autopsy in 13. Pneumocystis carinii pneumonia, candidiasis, lymphoma, Kaposi's sarcoma, toxoplasmosis and salmonellosis were more commonly diagnosed before death than at autopsy. By contrast, cytomegalovirus (CMV) infections and herpes simplex virus or varicella-zoster virus infections were more frequently diagnosed at postmortem examinations than prior to death. In conclusion, this study found substantial discrepancies between autopsy findings and premortem clinical diagnoses in AIDS patients, especially for CMV infection.