What are the signs and symptoms of pediatric HIV infection observed in the physical exam?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Signs and symptoms of pediatric HIV infection found during physical examination include the following:

  • Candidiasis: Most common oral and mucocutaneous presentation of HIV infection

  • Thrush in the oral cavity and posterior pharynx: Observed in approximately 30% of HIV-infected children

  • Linear gingival erythema and median rhomboid glossitis

  • Oral hairy leukoplakia

  • Parotid enlargement and recurrent aphthous ulcers

  • Herpetic infection with herpes simplex virus (HSV): May manifest as herpes labialis, gingivostomatitis, esophagitis, or chronic erosive, vesicular, and vegetating skin lesions; the involved areas of the lips, mouth, tongue, and esophagus are ulcerated

  • HIV dermatitis: An erythematous, papular rash; observed in about 25% of children with HIV infection

  • Dermatophytosis: Manifesting as an aggressive tinea capitis, corporis, versicolor, or onychomycosis

  • Pneumocystis jiroveci (formerly P carinii) pneumonia (PCP): Most commonly manifests as cough, dyspnea, tachypnea, and fever

  • Lipodystrophy: Presentations include peripheral lipoatrophy, truncal lipohypertrophy, and combined versions of these presentations; a more severe presentation occurs at puberty

  • Digital clubbing: As a result of chronic lung disease

  • Pitting or nonpitting edema in the extremities

  • Generalized cervical, axillary, or inguinal lymphadenopathy

See Clinical Presentation for more detail.

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