CXR Case 012

48 year old male presents with worsening dyspnoea, dry cough and hypoxia.

CXR CASE 012 LITFL

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.


TOP 150 CXR SERIES



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 |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.