The imaging features of nontuberculous mycobacterial immune reconstitution syndrome

The purpose was to characterize the spectrum of imaging findings of nontuberculous mycobacterial immune reconstitution syndrome in patients infected with the human immunodeficiency virus.

A retrospective review of 33 human immunodeficiency virus-infected patients with nontuberculous mycobacterial immune reconstitution syndrome was performed. Radiography, ultrasound, and computed tomography (CT) imaging was reviewed.

Intrathoracic and intra-abdominal abnormalities were identified in 16 and 14 patients, respectively. Lymphadenopathy was detected on chest radiographs in 11 patients and on CT in 13. Focal consolidation (n = 8) and centrilobular nodularity (n = 8) were common CT findings. Lymphadenopathy was the predominant abdominal finding (n = 10). Splenomegaly (n = 9), ascites (n = 7), and multiple hypoattenuating splenic lesions (n = 6) were additional findings. Peripheral lymph node masses were detected in 7 patients.

The most common manifestation of nontuberculous mycobacterial immune reconstitution syndrome is lymphadenopathy. Other common findings are pulmonary consolidation and centrilobular nodularity, ascites, splenomegaly, multiple hypoattenuating splenic lesions, and peripheral lymphadenopathy.