대한흉부영상의학회 Weekly Chest Cases

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

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,

대한흉부영상의학회 Korean Society of Thoracic Radiology