Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pneumocystis pneumonia (Pneumocystis Jirovecii infection)
- Radiologic Findings
- Posteroanterior chest radiograph shows bilateral consolidation with cystic change in middle lung zones.
Chest CT images demonstrate multiple cysts with surrounding ground glass opacities in both lungs, especially central zone.
The patient’s blood test result was positive for HIV. Sputum PCR for Pneumocystis jirovecii organisms was positive.
- Brief Review
- Pneumocystis jirovecii is an atypical fungus that causes pneumonia in immunocompromised human hosts particulary those with deficiency in cell-mediated immunity. On HRCT, extensive ground-glass opacity is the principal finding in PJP, reflecting accumulation of intra-alveolar fibrin, debris, and organisms. A predilection for the upper lobes has also been described. Pulmonary cysts with varying shape, size and wall thickness occur in as many as one third of patients with PJP. The incidence of pulmonary cysts has been reported to be lower in patients without HIV infection than in HIV-infected patients Although spontaneous pneumothorax can occur in the absence of definable lung cysts, the frequency of spontaneous pneumothorax increases with when definable lung cysts present. Cysts may resolve after treatment and clearing of infection
- Please refer to
Case 118, Case 797, Case 823, -
- References
- Jeffrey P. Kanne, Donald R. Yandow, Cristopher A. Meyer. Pneumocystis jiroveci Pneumonia: High-Resolution CT Findings in Patients With and Without HIV Infection, AJR 2012; 198:W555–W561
- Keywords
- Lung, Infection, Fungal infection, PCP,