The patient has AIDS. Developed shortness of breath in an inpatient setting. X-Ray was abnormal.
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Bilateral interlobular septal thickening on a background of ground glass shadowing, creating the crazy paving pattern. Bilateral pleural effusions.
The main differential diagnosis for this appearance is ARDS, bacterial pneumonia and PAP. However, since this patient is immune-suppressed, PCP was kept in mind.
Bronchoalveolar lavage and microscopy were performed thereafter, confirming Pneumocystis pneumonia.