26 year old retropositive lady with breathlessness
26-year-old retro-positive lady with breathlessness
- Fig 1-4. Axial inspiratory images. Extensive, bilateral perihilar ground-glass opacities and relative peripheral sparing.
- Fig 5,6. Coronal inspiratory images. Extensive, bilateral perihilar ground-glass opacities and relative peripheral sparing.
Diagnosis:
Pneumocystis jiroveci pneumonia
Discussion:
- Pneumocystis jiroveci pneumonia is common opportunistic infection in immunocompromised patients such as HIV positive.
- Imaging Findings on HRCT Chest:
- Bilateral extensive ground glass opacities with upper lobe predilection. Ground glass opacities may be central with relative peripheral sparing or diffuse with mosaic pattern.
- With advanced disease, crazy paving or consolidation may develop.
- Pulmonary cysts of variable size, shape and wall thickness may be present. Nodules may be present.
- Cysts are associated with spontaneous pneumothorax.
- Cysts resolve with resolution of infection.
References:
- Kanne JP, Yandow DR, Meyer CA. Pneumocystis jiroveci pneumonia: high-resolution CT findings in patients with and without HIV infection. American Journal of Roentgenology. 2012 Jun;198(6):W555-61.
Dr. Deepali Saxena,
DNB, Fellowship Cardiothoracic Imaging (USA)
Lead Cardiac Imaging
Manipal Hospitals Radiology Group.