HIV AIDS chest x ray: Difference between revisions

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==Overview==
==Overview==
Chest X-ray is an extremely common procedure done to evaluate the organs located in the chest area i.e. [[lungs]], [[heart]], and [[chest wall]].  It also helps in diagnosing the cause of various symptoms. (for example persistent [[cough]], [[shortness of breath]], [[chest pain]] or [[injury]], and [[fever]])
Chest X-ray is an extremely common procedure done to evaluate the organs located in the chest area i.e. [[lungs]], [[heart]], and [[chest wall]].  It also helps in diagnosing the cause of various symptoms. (for example persistent [[cough]], [[shortness of breath]], [[chest pain]] or [[injury]], and [[fever]])
==Chest X Ray==
==Overview==
HIV-infected patient presenting with unexplained [[pulmonary]] or constitutional symptoms should have a chest x ray as pulmonary manifestation is a complication increasing the morbidity and mortality of the patient.
Chest X-ray findings in HIV/AIDS are related to the development of opportunistic lung infections. They include ground-glass infiltrates suggestive of ''Pneumocystis jirovecii'' pneumonia, lobar consolidation, pleural effusions, loculated empyemas, and lymphadenopathy.
===Pneumocystis Pneumonia===
===Chest X Ray Findings===
The disease [[PCP]] is relatively rare in people with normal immune systems, but common among people with weakened [[immune system]]s, such as premature or severely [[malnourish]]ed children, the elderly, and especially persons living with HIV/AIDS, in whom it is most commonly observed.<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th | publisher = McGraw Hill | year = 2004 | isbn = 0838585299 }}</ref> PCP can also develop in patients who are taking [[Immunosuppressive drug|immunosuppressive medications]]. [[Chest x-ray]] shows widespread pulmonary infiltrates.
Chest X-ray findings in HIV/AIDS are related to the development of opportunistic lung infections. Common findings include:<ref name="pmid20981180">{{cite journal| author=Allen CM, Al-Jahdali HH, Irion KL, Al Ghanem S, Gouda A, Khan AN| title=Imaging lung manifestations of HIV/AIDS. | journal=Ann Thorac Med | year= 2010 | volume= 5 | issue= 4 | pages= 201-16 | pmid=20981180 | doi=10.4103/1817-1737.69106 | pmc=PMC2954374 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20981180  }} </ref>
 
*'''Diffuse ground-glass infiltrates'''
<gallery perRow="3">  Image:PCPxray.jpg|'''X-ray of Pneumocystis jirovecii pneumonia''' There is increased white (opacity) in the lower lungs on both sides, characteristic of ''Pneumocystis'' pneumonia  </gallery>
:* Suggestive of ''Pneumocystis jirovecii'' pneumonia
 
*'''Nodular infiltrates'''
===Bacterial Infection===
:* Suggestive of bacterial or fungal pneumonia
*It may be asymptomatic with normal chest xray in some patients
*'''Lobar/segmental consolidation'''
*In bacterial bronchiolitis , chest xray may be normal or can show lower lobar bronchial wall thickening which may be bilateral and symmetrical which gives the appearance of tram tracks or ring shadows.
:* Suggestive of bacterial or fungal pneumonia
*[[Parapneumonic effusions]] can be found as opaque shadows in xray
*'''Pleural effusion'''
*[[Empyema]] might be noted
:* Suggestive of empyema, parapneumonic effusion, tuberculous effusion, and malignant effusion
*[[Pneumonia]] can present as [[lobar]] or segmental [[consolidation]]<ref name="pmid20981180">{{cite journal| author=Allen CM, Al-Jahdali HH, Irion KL, Al Ghanem S, Gouda A, Khan AN| title=Imaging lung manifestations of HIV/AIDS. | journal=Ann Thorac Med | year= 2010 | volume= 5 | issue= 4 | pages= 201-16 | pmid=20981180 | doi=10.4103/1817-1737.69106 | pmc=PMC2954374 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20981180  }} </ref>
*'''Lobar consolidation'''
 
:* Suggestive of bacterial or fungal pneumonia
===Mycobacterial Infections===
*'''Hilar lymphadenopathy'''
*The radiological appearance of [[tuberculosis]] in AIDS present differently from a person with a normal immune system with more diffuse lower zone disease.
:* Suggestive of tuberculosis, malignancy, or may be secondary to HIV induced lymphadenopathy
*Increased [[lymphadenopathy]]
*'''Cavitation'''
*Increased incidence of miliary [[tuberculosis]]
:* Suggestive of tuberculosis, fungal infection, or necrotizing pneumonia
*Radiographic appearance reflects the CD4 count
*'''Mass lesion'''
:*Instances where CD4 level > 200, appearance is similar to reactivation of TB in an immunocompetant host. Regardless of prior exposure, classical primary TB can also be seen in patients .
:* Suggestive of malignancy, tuberculosis, or fungal infection
:*In contrast, patients with CD4 levels < 200 ,primary [[TB]] pattern is found regardless of prior exposure.
Reactivation of TB can have the following features.
*Patchy [[consolidation]], including involvement at unusual sites
*[[Cavitation]]
*[[Nodularity]]
*[[Effusions]]
*[[Adenopathy]]
 
Serial CXRs are useful for monitoring response to treatment<ref name="pmid20981180">{{cite journal| author=Allen CM, Al-Jahdali HH, Irion KL, Al Ghanem S, Gouda A, Khan AN| title=Imaging lung manifestations of HIV/AIDS. | journal=Ann Thorac Med | year= 2010 | volume= 5 | issue= 4 | pages= 201-16 | pmid=20981180 | doi=10.4103/1817-1737.69106 | pmc=PMC2954374 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20981180  }} </ref>
 
{{further|[[Tuberculosis]]}}


==References==
==References==

Revision as of 15:56, 5 November 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]; Ammu Susheela, M.D. [3]

Overview

Chest X-ray is an extremely common procedure done to evaluate the organs located in the chest area i.e. lungs, heart, and chest wall. It also helps in diagnosing the cause of various symptoms. (for example persistent cough, shortness of breath, chest pain or injury, and fever)

Overview

Chest X-ray findings in HIV/AIDS are related to the development of opportunistic lung infections. They include ground-glass infiltrates suggestive of Pneumocystis jirovecii pneumonia, lobar consolidation, pleural effusions, loculated empyemas, and lymphadenopathy.

Chest X Ray Findings

Chest X-ray findings in HIV/AIDS are related to the development of opportunistic lung infections. Common findings include:[1]

  • Diffuse ground-glass infiltrates
  • Suggestive of Pneumocystis jirovecii pneumonia
  • Nodular infiltrates
  • Suggestive of bacterial or fungal pneumonia
  • Lobar/segmental consolidation
  • Suggestive of bacterial or fungal pneumonia
  • Pleural effusion
  • Suggestive of empyema, parapneumonic effusion, tuberculous effusion, and malignant effusion
  • Lobar consolidation
  • Suggestive of bacterial or fungal pneumonia
  • Hilar lymphadenopathy
  • Suggestive of tuberculosis, malignancy, or may be secondary to HIV induced lymphadenopathy
  • Cavitation
  • Suggestive of tuberculosis, fungal infection, or necrotizing pneumonia
  • Mass lesion
  • Suggestive of malignancy, tuberculosis, or fungal infection

References

  1. ↑ Allen CM, Al-Jahdali HH, Irion KL, Al Ghanem S, Gouda A, Khan AN (2010). "Imaging lung manifestations of HIV/AIDS". Ann Thorac Med. 5 (4): 201–16. doi:10.4103/1817-1737.69106. PMC 2954374. PMID 20981180.

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