Fact-sheet: Pneumocystosis
Updated on 02/17/2022 at 4:02 PM
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Definition
Pneumocystis jirovecii pneumonia particularly affecting premature infants or immunocompromised patients (primary immunodeficiency, AIDS, hematologic malignancy)
Clinical features
Often acute presentation.
General deterioration.
Fever.
Dry cough, weight loss.
Hypoxemia.
Laboratory findings
Inflammatory syndrome.
Elevated LDH.
Lymphopenia with CD4 < 250/mL.
BAL or bronchoscopy: testing for Pneumocystis
Radiography
Normal initially, then interstitial pattern, bilateral symmetric perihilar opacities. Then bilateral alveolar opacities. Possible cystic or cavitary lucencies that may be complicated by pneumothorax.
CT
Normal initially.
Then bilateral symmetric perihilar ground-glass consolidations.
Then bilateral alveolar consolidations.
Possible cystic or cavitary lesions that may be complicated by pneumothorax.
Generally no perihilar lymphadenopathy.
Crazy paving pattern possible
Differential diagnosis
Possible association with alveolar proteinosis (crazy paving pattern).
CMV pneumonia: predominant ground-glass opacities