Presentation
Flu-like illness. Rash.
Patient Data
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Diffuse interstitial opacities are seen throughout both lungs with a mid-to-upper zone predominance.
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There are numerous small ill-defined lung nodules and groundglass opacities, particularly affecting the upper lobes. Atelectasis / fibrosis within the middle lobe medially.
The mediastinum appears normal. No pericardial effusion.
The patient proceeded to bronchoscopy and bronchoalveolar lavage:
Pneumocystis jiroveci DNA by PCR: Detected
Case Discussion
Pneumocysitis pneumonia is an atypical infection which typically has perihilar ground glass opacity. The nodules in this case are somewhat atypical and a differential diagnosis of tuberculosis was given on imaging appearances.