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Mentions: Cryptococcus is the fourth most common opportunistic infection in AIDS. The lungs are the portal of entry and the most common site of infection although, the common clinical presentation is with meningitis, pneumonia occurring in only approximately 30%. Imaging findings are varied and nonspecific. Reticular or reticulonodular infiltrates are the most common pattern [Figure 31]. Solitary or multiple nodules [Figure 32], often up to 4 cm in diameter, are seen in around 30%. Biopsy is usually required for diagnosis. Cavitation occurs less frequently in AIDS-related disease compared to immune competent hosts, usually appearing early in the course of the illness, when the level of immune suppression is mild [Figures 33 and 34]. Less-frequent manifestations include adenopathy, effusions, consolidation, miliary nodularity and ground-glass opacification and chest wall abscesses [Figure 35].
Imaging lung manifestations of HIV/AIDS
Bottom Line: The great majority of lung complications of HIV/AIDS are of infectious etiology but neoplasm, interstitial pneumonias, Kaposi sarcoma and lymphomas add significantly to patient morbidity and mortality.Imaging plays a vital role in the diagnosis and management of lung of complications associated with HIV.We present images of lung manifestations of HIV/AIDS, describing the salient features and the differential diagnosis.
Affiliation: North Manchester General Hospital, Pennine Acute NHS Trust, Manchester, UK.
Advances in our understanding of human immunodeficiency virus (HIV) infection have led to improved care and incremental increases in survival. However, the pulmonary manifestations of HIV/acquired immunodeficiency syndrome (AIDS) remain a major cause of morbidity and mortality. Respiratory complaints are not infrequent in patients who are HIV positive. The great majority of lung complications of HIV/AIDS are of infectious etiology but neoplasm, interstitial pneumonias, Kaposi sarcoma and lymphomas add significantly to patient morbidity and mortality. Imaging plays a vital role in the diagnosis and management of lung of complications associated with HIV. Accurate diagnosis is based on an understanding of the pathogenesis of the processes involved and their imaging findings. Imaging also plays an important role in selection of the most appropriate site for tissue sampling, staging of disease and follow-ups. We present images of lung manifestations of HIV/AIDS, describing the salient features and the differential diagnosis.