HIV AIDS chest x ray: Difference between revisions

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*[[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>
*[[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>


===Mycobacterial infections===
===Mycobacterial Infections===
*The radiological appearance of [[tuberculosis]] in AIDS present differently from a person with a normal immune system with more diffuse lower zone disease.
*The radiological appearance of [[tuberculosis]] in AIDS present differently from a person with a normal immune system with more diffuse lower zone disease.
*Increased [[lymphadenopathy]]
*Increased [[lymphadenopathy]]

Revision as of 15:28, 21 October 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)

Chest X Ray

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.

Pneumocystis Pneumonia

The disease PCP is relatively rare in people with normal immune systems, but common among people with weakened immune systems, such as premature or severely malnourished children, the elderly, and especially persons living with HIV/AIDS, in whom it is most commonly observed.[1] PCP can also develop in patients who are taking immunosuppressive medications. Chest x-ray shows widespread pulmonary infiltrates.

Bacterial Infection

  • It may be asymptomatic with normal chest xray in some patients
  • 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.
  • Parapneumonic effusions can be found as opaque shadows in xray
  • Empyema might be noted
  • Pneumonia can present as lobar or segmental consolidation[2]

Mycobacterial Infections

  • The radiological appearance of tuberculosis in AIDS present differently from a person with a normal immune system with more diffuse lower zone disease.
  • Increased lymphadenopathy
  • Increased incidence of miliary tuberculosis
  • Radiographic appearance reflects the CD4 count
  • 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 .
  • In contrast, patients with CD4 levels < 200 ,primary TB pattern is found regardless of prior exposure.

Reactivation of TB can have the following features.

Serial CXRs are useful for monitoring response to treatment[2]

References

  1. Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. ISBN 0838585299.
  2. 2.0 2.1 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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