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Radiographic features of paediatric pneumocystis pneumonia -- a historical perspective

R D Pitcher1, H J Zar

  • 1Division of Paediatric Radiology, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa. pitcher@iafrica.com

Clinical Radiology
|May 6, 2008
PubMed

Insights

Radiographic features of childhood Pneumocystis pneumonia (PCP) remain consistent across eras, even with human immunodeficiency virus (HIV). However, HIV-infected children in developed nations show earlier air cysts compared to uninfected peers.

Area of Science:

  • Pediatric Radiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Pneumocystis pneumonia (PCP) is a significant opportunistic infection in children, particularly those with human immunodeficiency virus (HIV).
  • Understanding the radiographic manifestations of pediatric PCP is crucial for timely diagnosis and management.
  • Radiographic features may evolve with changes in patient populations and disease prevalence, such as the HIV epidemic.

Purpose of the Study:

  • To compare plain radiographic features of pediatric PCP before and after the emergence of the HIV epidemic (pre-1982 vs. HIV era).
  • To identify differences in radiographic features of PCP in HIV-infected children between developed and developing countries.

Main Methods:

  • A comprehensive Medline search (1950-2006) was performed using keywords related to pediatric PCP and chest radiographic findings.
  • Radiological data were extracted from retrieved articles, and reference lists were examined for further relevant studies.
  • Hand searches of referenced articles were conducted to ensure thorough data collection.

Main Results:

  • Diffuse bilateral ground-glass or alveolar opacification, sometimes asymmetrical, is the most common radiographic finding in childhood PCP across all periods.
  • Less common features in children resemble those seen in adults.
  • PCP-related pulmonary air cysts appear earlier in HIV-infected children in developed countries compared to uninfected children. Air cysts, pneumothorax, and pneumomediastinum are reported in developed but not developing countries.

Conclusions:

  • The plain radiographic features of pediatric PCP have remained consistent, both before and during the HIV epidemic.
  • Further investigation is needed to understand the factors influencing the less common radiographic presentations of PCP in children.
Abstract

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