Unilateral calcification and contrast enhancement of the basal ganglia in a child with AIDS encephalopathy

For the majority of adults and children with AIDS, the disease is associated with neurologic manifestations. In children, a progressive encephalopathy has been described that often has characteristic findings on CT scans, including diffuse cerebral atrophy with secondary enlargement of the ventricular system and symmetrical bilateral calficifations of basal ganglia and white matter adjacent to the frontal horns. In addition, contrast enhancement of the basal ganglia has been noted in association with basal ganglia calcification. This report describes a child who presented with unilateral calcification and contrast enhancement of the basal ganglia, signs of a progressive encephalopathy, and evidence of infection with AIDS retrovirus HTLV-III/LAV (human T-lymphotropic virus type III/lymphadenopathy associated virus). The child did not have clinical AIDS. The presentation of HTLV-III/LAV infection in children with neurologic signs and symptoms associated with a focal finding on CT scan makes recognition of the characteristic radiographic appearance imperative for correct diagnosis.