Apical Pneumocystis carinii Pneumonia in AIDS Patients Not Receiving Inhaled Pentamidine Prophylaxis

Shin, Myung S.; Veal, C. F.; Jessup, John G.; Ho, Kang-Jey

doi:10.1378/chest.100.5.1462

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…The classic chest radiographic findings of patients with PCP include bilateral diffuse opacities [7]. However, some patients present with unusual chest radiographic findings [7,8]. In a multicenter study from the United States, the in-hospital mortality rate of hospitalized patients with cytologically confirmed PCP was 14% [9].…”

Section: Discussionmentioning

confidence: 99%

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

Afessa

2001

BMC Pulm Med

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Section: Discussionmentioning

confidence: 99%

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

Afessa

2001

BMC Pulm Med

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“…Proposed theories include a check-valve bronchiolar obstruction with distal cyst formation, elastase release from the macrophages with destruction of alveolar tissue, cytotoxic effect of HIV, or direct tissue destruction by Pneumocystis jirovecii. [9] Classically, PJP has symmetric ground-glass opacities radiating from the hilum on chest radiographs [10,16]. Computed tomography shows diffuse perihilar ground-glass opacities with peripheral subpleural sparing [11].…”

Section: Clinical and Imaging Findingsmentioning

confidence: 99%

“…It was postulated that these patients were susceptible to PJP at the lung apices since the inhaled pentamidine particles settled and did not reach the apex of the lung, leaving it vulnerable to infection [15]. In 1991, PJP in an apical distribution was described in 3 patients who did not receive pentamidine prophylaxis, suggesting that this could be an independent form of presentation [16]. Inhaled pentamidine fell out of favor after trimethoprim-sulfamethoxazole was showed to be equally effective against PJP, simultaneously provide coverage against toxoplasmosis, and be more cost-effective [17].…”

Section: Clinical and Imaging Findingsmentioning

confidence: 99%

Apical Pneumocystis jiroveci as an AIDS defining illness: A case report illustrating a change in the paradigm

et al. 2014

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Pneumocystis jiroveci pneumonia is a common acquired immune deficiency syndrome defining illness. Pneumocystis jiroveci pneumonia is classically described as having symmetrical bilateral perihilar ground-glass opacities on chest radiographs. We present an "atypical" case of Pneumocystis jiroveci pneumonia presenting as symmetric biapical cystic spaces with relative sparing of the remainder of the lungs in a 22 year-old male, previously undiagnosed with acquired immune deficiency syndrome. Our case illustrates that formerly unusual presentations of Pneumocystis jiroveci pneumonia are becoming more common as acquired immune deficiency syndrome defining illnesses as more patients are being imaged with further imaging such as high resolution computed tomography.

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Opportunistic pneumonia

Conces

1993

Current Problems in Diagnostic Radiology

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Patients with abnormalities in their immune defense mechanisms are frequently encountered in the practice of medicine. These patients have increased susceptibility to infections that often involve the lung. Many of these infections are caused by opportunistic organisms that typically do not produce disease in individuals with a normally functioning immune system. To complicate the evaluation of these patients, they frequently develop noninfectious lung disease, which can have a radiographic appearance that is similar to infection. The purpose of this article is to present an approach to the evaluation of chest radiographic abnormalities in the immunocompromised patient with suspected pneumonia. Clinical information that is pertinent in the evaluation of immunocompromised patients is discussed. The various chest radiographic patterns seen in both infectious and noninfectious diseases that occur in the immunocompromised patient are reviewed. Integration of clinical information and radiographic findings in the development of a list of differential diagnoses is stressed.

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Apical Pneumocystis carinii Pneumonia in AIDS Patients Not Receiving Inhaled Pentamidine Prophylaxis

Cited by 7 publications

References 12 publications

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

Apical Pneumocystis jiroveci as an AIDS defining illness: A case report illustrating a change in the paradigm

Opportunistic pneumonia

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