Thanks to Dr. Tracy Lin for an excellend case of newly diagnosed HIV presenting as PCP Pneumonia!

Learning Points:

-HIV often presents with opportunistic infections, including PCP pneumonia. PCP pneumonia in an HIV positive patient typically takes an indolent course with weeks to months dyspnea on exertion, fever, and dry cough. PCP pneumonia presents as a more acute and severe infection in immunocompetent patients.

-Findings suggestive of PCP pneumonia include and elevated LDH, diffuse interstitial infiltrates on CXR and patchy GGO on CT. Definitive diagnosis requires a bronchoscopy or BAL with staining or DFA.

– Click Here to read a Cochrane Review describing indications for corticosteroids in addition to Bactrim in severe cases of PCP Pneumonia.