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Weekly Chest CasesArchive of Old Cases

Case No : 436 Date 2006-03-06

  • Courtesy of Jae Seung Seo, MD, Byoung Wook Choi, MD, Kyu Ok Ch / Shinchon Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • Age/Sex 47 / M
  • Chief ComplaintIntermittent dyspnea for last three month with recent aggravation
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Diagnosis With Brief Discussion

Diagnosis
CMV Pneumonitis in HIV (+) Patient
Radiologic Findings
Initial chest radiograph showed subtle ground glass opacities (GGO) in both lungs. Axial lung setting view of chest CT revealed diffuse peribronchvascular and centrilobular GGO or consolidations in the both lungs, predominantly subpleural and lower lung area. Two months follow up chest radiograph showed progression of increased parenchymal opacities after steroid treatment. Axial lung setting view of chest CT revealed further aggravation of diffuse peribronchvascular and centrilobular GGOs and consolidations in the both lungs, predominantly subpleural and lower lung area. Laboratory studies showed negative results of eosinophilic count, P-ANCA, C-ANCA, ANA and rheumatoid factor. But HIV, CMV IgM, CMV PCR showed all positive results. Moreover, he had past history of anal sex twenty years ago. After cymevene treatment, two months follow up chest radiograph showed normal without patient’s symptoms.
Brief Review
References
Please also refer to Case 73, Case 143, Case 249 and Symposium1998-4
Keywords
Lung, Infection, Viral infection,

No. of Applicants : 32

▶ Correct Answer : 6/32,  18.8%
  • - National Taiwan University Hospital, Taiwan Yu-Feng Wei
  • - Jikei University Hospital, Tokyo, Japan Shigeki Misumi
  • - Yonsei University Hospital, Korea Eun Hye Yoo
  • - Homs National Hospital, Homs, Syria Rami Abou Zalaf
  • - Kangnam St. Mary Hospital, Korea ChaeHun Lim
  • - Yonsei University Severance Hospital, Korea Yong Eun Chung
▶ Correct Answer as Differential Diagnosis : 9/32,  28.1%
  • - Kashan Shahid Beheshti Hospital, Kashan, Iran Ebrahim Razi
  • - MYH, Indore, India Sonali Jain
  • - Hanyang University Hospital, Korea Yo Won Choi
  • - Pgimer, Chandigarg, India Ram Prakash Galwa
  • - Radiologie Guiton, La Rochelle, France Denis Chabassiere
  • - Annemasse, Polyclinique de Savoie, France Gay-Depassier Philippe
  • - Yonsei University Shinchon Severance Hospital, Korea Hye-Jeong Lee
  • - China Medical University Hospital,Taiwan Jun-Jun Yeh
  • - Cabinet de Radiologie Guiton, La Rochelle, France Jean-Luc Bigot
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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