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Intracranial human immunodeficiency virus infection in an infant: sonographic findings
1Department of Radiology, Mount Sinai Medical Center (CUNY), New York.
Insights
This case study reports the first sonographic findings of brain abnormalities in an infant with human immunodeficiency virus (HIV). These findings, including hyperechoic foci, suggest direct HIV infection of the brain.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Medical Imaging
Background:
- Infants with human immunodeficiency virus (HIV) can present with neurological impairment.
- Differential diagnosis for neurological symptoms in HIV-positive infants includes TORCH infections.
Observation:
- An eleven-month-old, HIV-positive infant presented with failure to thrive, recurrent infections, and progressive neurological decline.
- Head sonogram revealed multiple hyperechoic foci in the basal ganglia and periventricular white matter.
- Brain computed tomography (CT) scan showed punctate calcifications in the same areas.
Findings:
- Toxoplasmosis, Cytomegalovirus, and other TORCH infections were ruled out.
- The observed sonographic and CT findings suggest potential direct brain involvement by HIV.
- This case represents the initial documentation of these specific sonographic findings in the context of pediatric HIV.
Implications:
- These sonographic findings may serve as an early indicator of central nervous system involvement in HIV-infected infants.
- Further research is warranted to confirm the association between these imaging findings and direct HIV encephalopathy.
- Highlights the importance of neuroimaging in the comprehensive management of HIV-exposed and HIV-infected infants.
Abstract:
Multiple hyperechoic foci were noted on a head sonogram in the basal ganglia and periventricular white matter of an eleven month old, human immunodeficiency virus (HIV) seropositive male infant. The infant presented with failure to thrive, recurrent viral and bacterial infections, and progressive neurologic impairment. Toxoplasmosis, Cytomegalo-inclusion virus and other "TORCH" infections were excluded. A computed tomography (CT) scan of the brain demonstrated multiple punctate calcifications in the above areas. The literature indicates that these changes might be the result of direct HIV infection of the brain. To our knowledge this is the first reported case of the sonographic findings.