PDF(Pubmed)
Abstract：
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening condition found in immunocompromised individuals, especially in human immunodeficiency virus (HIV) positive patients. Here, we report a case of PCP in a presumably immunocompetent 25-year-old male patient who presented with a one-month history of chest pain, dyspnea, and a nonproductive cough with recent development of night sweats. The patient recently immigrated to the United States without any known medical or family history. A chest radiograph revealed moderate pneumothorax for which a chest tube was placed. A chest computed tomography (CT) scan revealed diffuse lung disease with multiple thin- and thick-walled cystic lesions on a background of diffuse ground-glass opacities. Based on these radiologic findings and subsequent positive HIV serology, there was a high suspicion of PCP. Bronchoalveolar lavage was performed, and PCR for Pneumocystis jirovecii was positive. Appropriate treatment was initiated, and the patient recovered well. Through this report, we aim to highlight the importance of recognizing the various clinical and radiologic findings of PCP even in patients with no overt risk factors. Prompt and targeted treatment could mitigate morbidity and mortality associated with this opportunistic pathogen.
摘要：
肺孢子虫肺炎（PCP）是一种在免疫功能低下的个体中发现的危及生命的疾病，特别是在人类免疫缺陷病毒（HIV）阳性患者中。这里,我们报告了一例PCP病例，其中一名可能有免疫能力的25岁男性患者有一个月的胸痛病史，呼吸困难,以及近期盗汗的非生产性咳嗽。患者最近移民到美国，没有任何已知的病史或家族史。胸部X光片显示中度气胸，并放置了胸管。胸部计算机断层扫描（CT）扫描显示弥漫性肺部疾病，在弥漫性磨玻璃混浊的背景下伴有多个薄壁和厚壁囊性病变。根据这些放射学发现和随后的HIV阳性血清学，对PCP的怀疑很大。进行支气管肺泡灌洗，和焦氏肺孢子虫PCR阳性。开始适当的治疗，病人恢复得很好。通过这份报告,我们的目的是强调认识到PCP的各种临床和影像学表现的重要性,即使是在没有明显危险因素的患者中.及时和有针对性的治疗可以减轻与这种机会病原体相关的发病率和死亡率。
