CTICasesLower Lobe-Predominant Bronchiectasis from Vertically Acquired HIV Infection
Imaging findings
A 28-year-old man has extensive tree-in-bud centrilobular nodules throughout both lungs along with bronchiectasis that is predominantly lower lobe in distribution, with bronchial wall thickening that renders the dilated airways only mildly enlarged in caliber.
Key takeaways
The patient has a history of chronic Pseudomonas and atypical mycobacterial infections related to vertically acquired HIV infection, and his mother has similarly severe lower lobe bronchiectasis from her own HIV infection. While lower lobe-predominant bronchiectasis is usually attributed to chronic aspiration or ciliary dyskinesia, chronic immunodeficiency from HIV is an important though less common cause to consider on the differential.
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