SPECTRUM OF CHEST RADIOGRAPHIC ABNORMALITIES IN CHILDREN WITH AIDS AND PNEUMOCYSTIS-CARINII PNEUMONIA

This report aims to provide a description of the spectrum of radiograp hic findings in children with AIDS and Pneumocystis carinii pneumonia (PCP). The chest radiographs of all children with perinatally transmit ted HIV infection who had PCP were reviewed. Thirty-eight episodes of PCP were noted in 32 children. The age range was 2-17 months. The radi ographic findings were characterized as to pattern, severity, presence of pulmonary air cyst, thoracic air leak, thoracic lymphadenopathy, a nd pleural effusion. The initial distribution of disease was as follow s: diffuse (n = 20), patchy (n = 12), focal (n = 4), nor mal (n = 2). In nearly one-third of children parenchymal abnormalities were mild en ough that most normal lung markings were visible, During the course of the illness pneumothorax was noted in eight cases, pulmonary air cyst in five, and pneumomediastinum in one. Pleural effusions were noted i n three (5%) cases, Thoracic lymphadenopathy was not observed in any c ase. The authors concluded that the initial chest radiographic appeara nce of PCP in children with AIDS is variable. The initial chest radiog raph may be normal. The distribution was patchy or focal in nearly one -half of all cases with parenchymal abnormalities. Pulmonary air cysts or thoracic air leaks were noted during the course of the illness in approximately one-third of all cases.