Presentation
Fever, cough, and dyspnea for 15-20 days.
Patient Data
Extensive patchy confluent areas of reticular interstitial thickening with surrounding ground glass opacities in the bilateral lung, predominantly involving the bilateral upper lobes. A few small cysts in the left upper lobe.
The bronchoalveolar lavage (BAL) fluid was positive for Pneumocystis jirovecii.
Case Discussion
Pneumocystis pneumonia is an opportunist infection which often presents with progressive symptoms over a few weeks, depending on the degree of immunocompromise. This patient was positive for HIV-1 and HIV-2 antibodies.
Bronchoalveolar lavage fluid was positive for Pneumocystis jirovecii. The potassium hydroxide mount was negative for fungal elements; gram stain and PCR were negative for Mycobacterium tuberculosis. The CD4 count was only 4 cells/mm3.
Co-author: Dr. Saket Sharma (DM, Pulmonary medicine).
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