[Abdominal manifestations in immunocompromised patients]

Area of Science:

• Radiology and Imaging
• Immunocompromised Host Diseases

Background:

• Abdominal infections and tumors are common in Acquired Immunodeficiency Syndrome (AIDS) but rare in transplant recipients.
• Diagnostic imaging roles vary based on specific symptoms (e.g., dysphagia, jaundice) versus nonspecific findings (e.g., fever, abdominal pain).

Purpose of the Study:

• To delineate the distinct roles of diagnostic imaging modalities in immunocompromised patients, specifically those with Acquired Immunodeficiency Syndrome (AIDS) and transplant recipients.
• To evaluate the utility of various imaging techniques in diagnosing abdominal pathologies in immunocompromised hosts presenting with diverse clinical symptoms.

Main Methods:

• Review of diagnostic imaging modalities including X-ray barium studies, computed tomography (CT), and ultrasonography (US).
• Analysis of imaging findings in relation to specific symptoms (dysphagia, diarrhea, malabsorption, jaundice) and nonspecific findings (fever, weight loss, lymphadenopathy, abdominal pain).
• Emphasis on CT and US for deep lymphadenopathies, focal parenchymal lesions, and guiding percutaneous needle biopsies.

Main Results:

• X-ray barium studies provide information on infections (Candida, Cytomegalovirus, Mycobacterium avium intracellulare, Cryptococcus) and malignancies (Kaposi's sarcoma, gastrointestinal lymphoma).
• CT findings can suggest diagnoses for infections and tumors, and differentiate mycobacterial infections from neoplastic lesions based on location and density.
• US and CT are effective in demonstrating deep lymphadenopathies and focal lesions, aiding in diagnosis and guiding biopsies.

Conclusions:

• In patients with specific gastrointestinal symptoms, radiology is ancillary to endoscopy, though barium studies offer valuable diagnostic information.
• For nonspecific symptoms, US and CT are crucial for detecting deep-seated lesions and guiding biopsies, with CT distinguishing between infections and tumors.
• US and CT are essential tools for monitoring Human Immunodeficiency Virus (HIV)-positive individuals, managing AIDS patients, and following transplant recipients.