Pediatric AIDS-Related Myocarditis: Focal Cardiac Gallium Uptake

A 10-month-old boy with AIDS presented with fever, grunting, diarrhea, and irritability. Plain radiography revealed progressive enlargement of the cardiopericardial silhouette, clear lung fields, a small left pleural effusion, and hepatomegaly. Abdominal ultrasound revealed cardiac enlargement, a small pericardial effusion, and hepatomegaly. Gallium imaging excluded recurrent Pneumocystis carlnii pneumonia and revealed intense cardiac uptake. The child died suddenly from a cardiac dysrhythmia. Emergent pericardiocentesis and other cultures were negative for pathogens. Autopsy was not performed.The etiology of pediatric HIV-associated myocarditis remains unknown. Infectious pathogens are rarely isolated. Associated small sterile pericardial effusions are frequent.