The early chest radiographic changes of Pneumocystis pneumonia

In a retrospective 3-year survey, 14 immunosuppressed patients from a renal unit were diagnosed as having Pneumocystis pneumonia. All 14 patients had a chest radiograph taken within 48 h of the onset of the acute illness. In only three out of the 14 cases did the radiograph show 'classical' bilateral perihilar infiltration: In six the film was normal and in five there were minimal non-specific changes only. We conclude that normal radiographic appearances are common in the early stages of Pneumocystis pneumonia and 'classical' radiological features are rarely seen.