Pneumocystis jirovecii pneumonia

Case contributed by Dr Madeleine Scicchitano

Presentation

Fevers, night sweats and weight loss. Known HIV positive with CD4 count 25 cells/mm3.

Patient Data

Age: 40 years
Gender: Male

Multifocal bilateral patchy areas of ground-glass opacity involving all lobes. 

Small pneumatocoele with multiple septae in the right lower lobe. 

The findings are consistent with atypical pulmonary infection, most likely pneumocystis jirovecii given the history and imaging features. 

Case Discussion

This case demonstrates the classic ground-glass multifocal densities seen in pulmonary pneumocystis jirovecii (PJP) infection, predominantly involving the mid-zones.

In addition there is a small pneumatocoele which can also be a feature.

The disease invariably affects patients who are immunocompromised and, in the case of those infected with HIV, typically occurs at CD4 count < 200 cells/mm3

Pulmonary PJP is an AIDS defining illness. 

Case with thanks to Dr Matthew Lukies. 

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Case information

rID: 69201
Published: 2nd Jul 2019
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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