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Gymnast Wrist
Heather Borders, MD
over 10 years ago
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Anatomy: Neck-Face
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 11 years ago
Updated: over 11 years ago
Tags: PEDS
Modality/Study Types: CT
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4 year old with congenital HIV infection and facial pain and swelling.

Case Images




CT – Axial and coronal images show marked enlargement of the parotid glands which contain small cystic spaces. Also note the cervical and axillary adenopathy.


About 5% of HIV positive patients develop changes in their parotid glands prior to the onset of AIDS. There are two main patterns of disease, diffuse periductal CD8 T-lymphocyte cell aggregation and benign lymphoepithelial cysts forms. The parotid glands become diffusely enlarged and may be painful. If left untreated, slow progression followed by regression occurs.

Viral etiologies of sialadenitis including mumps (paramyxovirus), Coxsackie A, Epstein-Barr virus and cytomegalovirus as well as autoimmune disease could be considered.

Adenoidal, facial and lingual tonsillar hypertrophy and reactive cervical lymphadenopathy are commonly associated with HIV sialadenitis.


Liyanage SH, et al. Imaging of salivary glands. Imaging (2007); 19:14-27.

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