Comparison between the Radiographic Findings in Pulmonary Tuberculosis of Children with or without HIV Infection
Jiraporn Srinakarin MD*, Netdao Roongpittayanon MD*, Jamaree Teeratakulpisarn MD**, Pope Kosalaraksa MD**, Tula Dhiensiri MD*
Affiliation : * Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : Identify the difference between radiographic fi ndings in children with pulmonary tuberculosis with and without
HIV infection.
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
