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Pneumocystis jirovecii pneumonia

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain

Presentation

Adult female with positive HIV infection and low CD4 count. Shortness of breath and cough.

Patient Data

Age: 40 years
Gender: Female
x-ray

The visualized lung fields show hazy opacification with peribronchial and some interstitial prominence in the form of fine reticular interstitial pulmonary pattern. The case showed progressive deterioration as shown from the demonstrated XR sequences. The last one shows more diffuse infiltrates with ET tube insertion in ventilated victim.

Diffuse bilateral reticular opacities or septal thickening are present. A crazy paving pattern may therefore be seen when both ground-glass opacies and septal thickening are superimposed on one another.

Case Discussion

This proved to be pneumocystis jirovecii pneumonia in an HIV positive patient. In the next few days her general condition deteriorated, so patient was admitted to ICU and ventilated, but unfortunately passed away.

Pneumocystis jirovecii pneumonia is an atypical pulmonary infection, the most common opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS).

Classically, PCP was the acronym for pneumocystis carinii pneumonia, but was reclassified as pneumocystis jirovecii. Pneumocystis carinii refers to a species found in rats, but pneumocystis jirovecii refers to the human isolate.  

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