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Miliary Pneumocystis jiroveci pneumonia in a patient living with HIV
Yasemin Çakır Kıymaz1, Seyit Ali Büyüktuna1
1Department of Infectious Diseases, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey.
Abstract:
Pneumocystis jirovecii pneumonia (PJP) is one of the leading opportunistic infections seen in people living with HIV. Bilateral infiltrations characterize PJP and miliary involvement is very rare. In this article, we report a 32-year-old person living with HIV who was followed up with a diagnosis of miliary PJP. Our patient was admitted to the hospital with complaints of cough, sputum, and weight loss. Initially, miliary tuberculosis was considered due to the presence of miliary involvement on chest radiography, but the diagnosis was made with P. jirovecii PCR positivity. This article aims to report a case of miliary PJP, a rare clinical form of PJP.
Insights
Miliary Pneumocystis pneumonia (PJP) is a rare presentation in people with HIV. This case highlights the importance of considering PJP in HIV patients with miliary patterns on imaging, even when tuberculosis is suspected.
Area of Science:
- Infectious Diseases
- Pulmonology
- HIV Medicine
Background:
- Pneumocystis jirovecii pneumonia (PJP) is a significant opportunistic infection in individuals with advanced HIV.
- Typical PJP presents with bilateral infiltrates on chest imaging.
- Miliary involvement, a rare manifestation, can complicate diagnosis.
Observation:
- A 32-year-old person living with HIV presented with cough, sputum, and weight loss.
- Chest radiography revealed a miliary pattern, initially suggesting miliary tuberculosis.
- Diagnosis was confirmed via Pneumocystis jirovecii Polymerase Chain Reaction (PCR) positivity.
Findings:
- The patient was diagnosed with miliary PJP, an uncommon clinical presentation.
- PCR testing proved crucial in differentiating miliary PJP from miliary tuberculosis.
Implications:
- This case underscores the diagnostic challenge posed by rare PJP presentations.
- Early and accurate diagnosis of miliary PJP is vital for appropriate treatment in immunocompromised individuals.
- Highlights the need for considering PJP in HIV patients with miliary patterns, irrespective of initial differential diagnoses.
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