Multiple Mass Lesions in Pneumocystis Pneumonia

Area of Science:

• Medical diagnostics
• Infectious diseases
• Pulmonology

Background:

• Pneumocystis pneumonia (PCP) is an opportunistic infection.
• Diagnosis typically relies on characteristic imaging and biomarkers.
• Atypical presentations can challenge diagnosis.

Observation:

• A human immunodeficiency virus (HIV)-negative patient presented with multiple lung mass lesions.
• Chest computed tomography (CT) findings were not typical for PCP.
• Serum (1,3)-β-D-glucan levels were within normal limits.

Findings:

• Bronchoscopic biopsy with Grocott's staining confirmed PCP.
• PCP exhibits diverse chest CT patterns influenced by host immune status.
• Grocott's staining is a reliable diagnostic method for PCP.

Implications:

• Consider bronchoscopy for suspected PCP in high-risk patients, irrespective of typical CT findings.
• This case highlights the importance of invasive diagnostics for challenging PCP diagnoses.
• Understanding varied PCP imaging manifestations is critical for timely patient management.