Lung infections in HIV-infected children: imaging pattern recognition and its correlation with CD4 counts Article Swipe
Vishal Goel
,
Mahender K. Narula
,
Shahina Bano
,
Rama Anand
,
Vikas Chaudhary
,
Varinder Singh
,
Sonal Saxena
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1186/s43055-024-01240-z
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1186/s43055-024-01240-z
Context Children with human immunodeficiency virus (HIV) infection frequently present with opportunistic infections of the lung that may be associated with high mortality rate. There is no study, to the best of our knowledge, correlating specific radiographic patterns of chest infections with CD4 levels of immunity in HIV-infected children of Indian subcontinent (where prevalence of respiratory tuberculosis is very high). Aims To study the radiological patterns of chest infections in HIV-infected children, and to correlate these radiological findings with CD4 cell count and final diagnosis. Methods Forty-five HIV-infected children (1–18 years of age) with suspected chest infections were included in the study. The baseline and the most recent CD4 counts were recorded for each patient. Chest X-ray (CXR) was obtained in all the patients, and multi-detector computed tomography (MDCT) chest was done in 27 patients having clinical suspicion of infection with normal or equivocal findings on CXR. Chest radiographs and MDCT chest were analyzed for different radiological patterns of chest infections. Imaging findings were correlated with CD4 count range for disease spectrum. The final etiopathological diagnosis was achieved in combination with clinico-radiological findings, laboratory data, cytohistopathology and follow-up imaging. Results Out of 45 children confirmed to be HIV-infected, 27 (60%) had bacterial infection, 14 (31.11%) had tuberculosis, and four (8.89%) had fungal infection. Consolidation on CXR/CT strongly suggested bacterial etiology ( P < 0.05 ). Mediastinal/hilar lymphadenopathy (with or without necrosis) strongly suggested tubercular etiology ( P value < 0.05). Diffuse GGO/haziness on CXR/CT strongly suggested fungal etiology ( P value < 0.05). On correlation with CD4 count (cells/mm 3 ), the bacterial infections occurred at early stages of HIV infection when immune status was relatively preserved, and most of the patients with tubercular infection had moderate immunosuppression. On the other hand, all patients of fungal infection showed severe immunosuppression. Conclusion A wide spectrum of pulmonary disease encountered in HIV-infected children warrants an integrated approach of image interpretation. Familiarity with the imaging patterns, combined with relevant clinical/laboratory details, may greatly help to improve the diagnostic confidence and to reach to a more meaningful differential diagnosis.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1186/s43055-024-01240-z
- https://ejrnm.springeropen.com/counter/pdf/10.1186/s43055-024-01240-z
- OA Status
- diamond
- References
- 19
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4393949645
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- OpenAlex ID
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https://openalex.org/W4393949645Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1186/s43055-024-01240-zDigital Object Identifier
- Title
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Lung infections in HIV-infected children: imaging pattern recognition and its correlation with CD4 countsWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-04-04Full publication date if available
- Authors
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Vishal Goel, Mahender K. Narula, Shahina Bano, Rama Anand, Vikas Chaudhary, Varinder Singh, Sonal SaxenaList of authors in order
- Landing page
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https://doi.org/10.1186/s43055-024-01240-zPublisher landing page
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https://ejrnm.springeropen.com/counter/pdf/10.1186/s43055-024-01240-zDirect link to full text PDF
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YesWhether a free full text is available
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diamondOpen access status per OpenAlex
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https://ejrnm.springeropen.com/counter/pdf/10.1186/s43055-024-01240-zDirect OA link when available
- Concepts
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Correlation, Human immunodeficiency virus (HIV), Lung, Lung infection, Medicine, Virology, Pathology, Immunology, Internal medicine, Mathematics, GeometryTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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