Tuesday, September 11, 2012

Pericardial Effusions in HIV Infection

The above image is from a patient with a history of HIV and lymphoma. CECT demonstrates a thickened, enhancing pericardium with a complex pericardial effusion. Bilateral pleural effusions, right greater than left, are also noted. 

Pericardial effusions are the most common cardiovascular complication of HIV infection and usually carry a poor prognosis. The majority of cases are due to an idiopathic cause. Other causes that must be considered in this population are tuberculosis, bacterial infection (S. aureus is the most common), malignancy (lymphoma and Kaposi's sarcoma), viral, and fungal.

Chen Y, Brennessel D, Walters J, et al. Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature. Am Heart J 1999;137(3):516-21.
Restrepo CD, Diethelm L, Lemos JA, et al. Cardiovascular complications of human immunodeficiency virus. Radiographics 2006;26:213-31.
Wang ZJ, Reddy GP, Gotway MB, et al. CT and MR imaging of pericardial disease. Radiographics 2003;23:S167-80.

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