This Article Summary Full Text Full Text (PDF) Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jeanes, A C Articles by Owens, C M Search for Related Content PubMed Articles by Jeanes, A C Articles by Owens, C M

Imaging of HIV disease in children

Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK

View larger version (131K): [in a new window]   Figure 1. Staphylococcal pneumonia. Posteroanterior chest radiograph demonstrating right upper lobe consolidation. Staphylococcus aureus was isolated from blood cultures.

View larger version (72K): [in a new window]   Figure 2. Pneumocystis carinii pneumonia (PCP). (a) Anteroposterior (AP) chest radiograph in a 2-year-old child with vertically acquired HIV, demonstrating marked hyperinflation and bilateral, predominantly upper zoneconsolidation typical of PCP. (b) AP chest radiograph in a 6-month-old Nigerian child following an acute presentation with respiratory distress, demonstrating diffuse bilateral consolidation. Pneumocystis carinii was isolated from bronchio-alveolar lavage fluid.

View larger version (176K): [in a new window]   Figure 3. Pneumocystis carinii pneumonia. Anteroposterior chest radiograph demonstrating predominantly upper lobe consolidation complicated by a left-sided tension pneumothorax and pneumomediastinum.

View larger version (147K): [in a new window]   Figure 4. Pneumocystis carinii pneumonia (PCP). (a)High resolution CT in a 9-month-old HIV-positive child, demonstrating patchy mosaic ground-glass opacity highly suggestive of PCP. Pneumocystis carinii was confirmed on bronchio-alveolar lavage.

View larger version (147K): [in a new window]   Figure 5. Lymphocytic interstitial pneumonitis (LIP). Posteroanterior chest radiograph in a 2-year-old child, demonstrating hilar lymphadenopathy and multiple parenchymal nodules typical of LIP.

View larger version (138K): [in a new window]   Figure 6. Mycobacterium tuberculosis. Anteroposterior chest radiograph in an 18-month-oldHIV-positive child, demonstrating right upper lobe consolidation typical of primary tuberculosis.

View larger version (109K): [in a new window]   Figure 7. Miliary tuberculosis. High resolution CT demonstrating multiple widespread centrilobular nodules.

View larger version (120K): [in a new window]   Figure 8. Cytomegalovirus (CMV) pneumonitis complicated by Adult Respiratory Distress Syndrome. Anteroposterior chest radiograph demonstrating hilar and mediastinal lymphadenopathy, with bilateral widespread air space consolidation. CMV was isolated from nasopharyngeal aspirate.

View larger version (139K): [in a new window]   Figure 9. Varicella-Zoster virus pneumonia. Anteroposterior chest radiograph demonstrating widespread nodules, which have become confluent at the right lung base.

View larger version (129K): [in a new window]   Figure 10. Cytomegalovirus (CMV) colitis. Plain abdominal radiograph demonstrates abdominal distension and marked subserosal (arrows) and intramural gas due to CMV colitis. Pneumatosis intestinalis can also occur with other viral and bacterial infections such as rota virus, cryptosporidium and Clostridium difficile.

View larger version (71K): [in a new window]   Figure 11. Mycobacterium avium intracellulare (MAI). (a) Ultrasound of the abdomen in a 12-year-old girl with AIDSdemonstrates bulky echo-poor mesenteric adenopathy. (b) Contrast enhanced CT abdomen of the same child, demonstrating characteristic low density ring enhancing lymphadenopathy (arrow). MAI was cultured from stools.

View larger version (123K): [in a new window]   Figure 12. Diffuse infiltrative lymphocytosis syndrome (DILS). High resolution ultrasound of the right parotid gland demonstrates multiple hypoechoic lymphoepithelial cysts.

View larger version (109K): [in a new window]   Figure 13. Non-Hodgkins B-cell lymphoma. High resolution ultrasound of the spleen in a child with AIDS-related lymphoma, demonstrating a focal hypoechoic splenic lesion.

View larger version (91K): [in a new window]   Figure 14. Abdominal Burkitt's lymphoma. (a) CT abdomen following intravenous contrast medium, demonstrating ascites, peritoneal and mesenteric infiltration, and dilatation of the common bile duct secondary to infiltration of the porta hepatis (arrow). (b) Ultrasound of the abdomen of the same child using a high resolution linear array transducer demonstrates echo-poor peritoneal nodules and extensive mesenteric infiltration (arrow).

View larger version (137K): [in a new window]   Figure 15. HIV encephalopathy. (a) Axial non-contrast CT of the head in a 5-month-old boy demonstrates typical appearances of HIV atrophy with ventricular enlargement and prominence of the cortical sulci.

View larger version (127K): [in a new window]   Figure 16. HIV encephalopathy. (a) Axial T2 weighted spin echo MRI demonstrating mild cortical atrophy with high signal within the periventricular white matter.

View larger version (124K): [in a new window]   Figure 17. Axial non-contrast CT of the head in a 10-year-old girl, demonstrating a right frontal infarct and basal ganglia calcification. Thrombophilia screen demonstrated protein S deficiency.

View larger version (154K): [in a new window]   Figure 18. Sagittal ultrasound of the head in a 3-month-old child with HIV, demonstrating typical linear appearances of early basal ganglia calcification within lenticulostriate vessels (arrows).

View larger version (103K): [in a new window]   Figure 19. Cerebral toxoplasmosis. (a) T1 weighted and (b) T2 weighted spin echo MRI demonstrates two focal periventicular basal ganglia lesions, which are of intermediate signal on T1 weighting and demonstrate marked perilesional high signal compatible with oedema on T2 weighting.

View larger version (127K): [in a new window]   Figure 20. Central nervous system B-cell non-Hodgkin's lymphoma (NHL). T2 weighted spin echo MRI of the brain in a 7-year-old girl, demonstrating a large solitary right frontal mixed signal mass lesion with local mass effect. Biopsy confirmed B-cell NHL.

View larger version (89K): [in a new window]   Figure 21. Soft tissue Mycobacterium avium intracellulare infection. Axial T2 weighted spin echo MRI of both thighs demonstrates focal areas of increased signal within the subcutaneous fat of the left buttock and right anterior leg, with high signal tracking along the fascial planes of sartorius (arrow).

View larger version (76K): [in a new window]   Figure 22. Septic arthritis. (a) Radiograph of the left shoulder in a 14-year-old HIV-positive boy demonstrates marked soft tissue swelling inferomedial to the glenoid. (b) High resolution ultrasound in the same child demonstrates a large complex collection within the infraglenoid bursa. Multiple granulomata were isolated from synovial biopsies, and empirical anti-tuberculous chemotherapy was commenced. Neither Mycobacterium tuberculosis or non-tuberculous mycobacterium were identified on microscopy or culture.