Finger clubbing in children with human immunodeficiency virus infection.
We investigated the frequency of finger clubbing in 150 HIV-infected children consecutively hospitalized for acute pneumonia in South Africa and described associated clinical, laboratory and radiological features. Clubbing occurred in 30 of 150 (20%) HIV-infected children compared with one of 99 (1%) HIV-negative control patients, p < 0.001. Clubbing was associated with lower presenting heart and respiratory rates and enlarged parotid glands. Total and CD4 + lymphocytes, CD4:CD8 ratio and LDH were lower in children with clubbing, but serum protein and gammaglobulin were higher. No differences in the prevalence or type of microbial pathogens were found between the two groups. Clubbing was associated with a radiological diagnosis of LIP. Children with clubbing had a lower in-hospital mortality rate than those without clubbing (6.7% vs 24.2%, p = 0.035). In geographical areas with high HIV seroprevalence rates, the presence of clubbing in a child hospitalized for respiratory disease should raise the suspicion of HIV infection.
Zar
H J
HJ
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa. heather@rmh.uct.ac.za
Hussey
G
G
D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000276:immunology; D008297:Male; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies