CXR Case 012
48 year old male presents with worsening dyspnoea, dry cough and hypoxia.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There are bilateral perihilar infiltrates and consolidation.
This is most likely Pneumocystis Jiroveci Pneumonia (PJP)
CLINICAL CORRELATION
Pneumocystis jiroveci is a yeast like fungus that causes pneumonia in the immune suppressed.
* In this case the patient had finished treatment for lymphoma >2 years ago, but had stayed on dexamethsone 3 times a week. *
Diagnosis can be on characteristic clinical grounds, although isolation of the organism or positive PCR from induced sputum or brochoscopy is more desirable.
CLINICAL PEARLS
The term ‘PCP‘ is equally valid, although refers to when the causative organism was thought to be pneumocystis carinii, which in fact only affects pigs.
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ
Hi, just curious, without the clinical history details- why can’t it be dx as worsening heart failure, as to me it looks like pulmonary edema with the bat wings, with cardiomegaly?
I was thinking the same as well!