Presentation
History of HIV, loss of viral suppression, a few weeks of shortness of breath, cough, malaise and weight loss.
Patient Data
Although there is no focus of airspace opacification, there is hazy ground glass involving both lungs and a reticular pattern of opacification.
The lungs are of normal volume, there is no collapse and no pleural effusion. Further features in the history were gradual weight loss.
A whole body CT was performed to look for sources of infection and lymphadenopathy.
A mid and lower zone diffuse ground glass pattern was seen, with admixed areas of interlobular septal thickening, giving a "crazy paving" pattern. Some small cystic spaces were observed too.
No nodules, nodes or pleural effusions were seen. The heart was not enlarged.
Case Discussion
A diagnosis of pneumocystis pneumonia (PCP) was made, the causative organism of which is Pneumocystis jirovecii. This is seen almost exclusively in immunocompromised patients, particularly those with AIDS.
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