Material and Method: The authors retrospectively reviewed the chest radiography of 93 children (under 15 years of age) with pulmonary tuberculosis between January 2000 and June 2005. Fifty-two of the children had an HIV co-infection while the remaining 41 children did not. The chest radiographic fi ndings were assessed for parenchymal changes, lymphadenopathy, and pleural effusion.

Results: The radiographic manifestations in the HIV-infected group included interstitial infi ltration in 39 patients (75%), alveolar infi ltration in fi ve patients (9.6%), combined interstitial and alveolar infi ltration in seven patients (13.4%), miliary infi ltration in one patient (1.9%), and hilar/mediastinal lymphadenopathy in 17 patients (32.6%). One patient had extensive alveolar infi ltration in conjunction with multiple cavitatary formations. The fi ndings in the non-HIV-infected group were interstitial infi ltration in 30 patients (73.1%), hilar/mediastinal lymphadenopathy in 13 patients (31.7%, 3 of whom had adenopathy without parenchymal infi ltration), and pleural effusion in two patients (4.8%). Other less frequent abnormalities included bronchiectasis, peribronchial thickening in the HIV-infected group, and atelectasis and granuloma in the non-HIV-infected group. There was no statistically signifi cant difference in the radiographic fi ndings between the two groups, except the association of hilar/mediastinal lymphadenopathy and pulmonary infi ltration. Regarding hilar/mediastinal lymphadenopathy with or without pulmonary infi ltration between the two groups, all cases in the HIV-infected group with hilar/mediastinal lymphadenopathy were signifi cantly more associated with pulmonary infi ltration (17 patients) than the other group (8 patients) (p = 0.009).

Conclusion: Hilar/mediastinal lymphadenopathy with pulmonary infi ltration strongly suggests the presence of HIV infection in children with pulmonary tuberculosis.

Keywords: Pulmonary tuberculosis, Radiographic fi ndings, Children, HIV infection