Pneumocystis pneumonia

Case contributed by Hani Makky Al Salam


Recently diagnosed HIV presented with shortness of breath.

Patient Data

Age: 30 years
Gender: Male

Day 0


Right upper zone opacity. 

Day 5


CT obtained 5 days later demonstrates widepread ground glass attenuation, with a predeliction for the dependent portions of the lungs. Small bilateral pleural effusions are present. 

The diagnosis of pneumocystis jirovecii pneumonia was confirmed with bronchoalveolar lavage.

Day 6


CXR the next day demonstrates further worsening of the parenchymal attenuation. 

Day 11


The patient continued to deteriorate and necessitated intubation. Consolidation is progressive. 

Case Discussion

With treatment, this patient is likely to recover. PCP, once very common in HIV positive patients, is far less frequently encountered as both antiretroviral therapy (ART) and prophylaxis are effective. 

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