Granulomatous Pneumocystis jiroveci Pneumonia in an HIV-Positive Patient on Antiretroviral Therapy: A Diagnostic Challenge.
| Autor: | Diaz-Abad M; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Robinett KS; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Lasso-Pirot A; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA., Legesse TB; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA., Khambaty M; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The open respiratory medicine journal [Open Respir Med J] 2021 Jun 18; Vol. 15, pp. 19-22. Date of Electronic Publication: 2021 Jun 18 (Print Publication: 2021). |
| DOI: | 10.2174/1874306402115010019 |
| Abstrakt: | Human Immunodeficiency Virus (HIV)-related Opportunistic Infections (OI), including Pneumocystis jiroveci pneumonia (PCP), have become much less commonplace with anti-retroviral therapy (ART). Despite this, OIs are still common and it is important to remain vigilant for their presence and be aware of how ART and OI chemoprophylaxis may lead to atypical disease presentations. We present the case of a 51-year-old woman with HIV and CD4+ T helper lymphocytes cell count > 200 cells/ul on both ART and trimethoprim/sulfamethoxazole prophylaxis who presented with cavitating lung masses, mediastinal lymphadenopathy and pleural effusions. Negative bronchoalveolar lavage (BAL) and transbronchial biopsy (TBBx) prompted a second diagnostic procedure with a transthoracic core needle biopsy; the final diagnosis was granulomatous PCP. This case showcases a very rare presentation of PCP, with both large cavitating lung masses on imaging and granulomatous reaction on pathology, as well as the challenge of a potentially missed diagnosis with negative BAL and TBBx requiring transthoracic core needle biopsy for a final diagnosis. (© 2021 Diaz-Abad et al.) |
| Databáze: | MEDLINE |
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