Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report

Pneumocystis jirovecii is a potentially life-threatening opportunistic pathogen particularly affecting the lungs, mainly in immunosuppressed individuals and HIV-infected patients with a low CD4 cell count. A 50-year-old man presented with a 1-week history of pleuritic chest pain and fever. He was al...

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Main Authors: Selin KESTEL KAYIK, Elif ACAR, Leyla MEMİŞ
Format: Article
Language:English
Published: Federation of Turkish Pathology Societies 2020-09-01
Series:Türk Patoloji Dergisi
Subjects:
Online Access: http://www.turkjpath.org/pdf.php3?id=1917
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author Selin KESTEL KAYIK
Elif ACAR
Leyla MEMİŞ
author_facet Selin KESTEL KAYIK
Elif ACAR
Leyla MEMİŞ
author_sort Selin KESTEL KAYIK
collection DOAJ
description Pneumocystis jirovecii is a potentially life-threatening opportunistic pathogen particularly affecting the lungs, mainly in immunosuppressed individuals and HIV-infected patients with a low CD4 cell count. A 50-year-old man presented with a 1-week history of pleuritic chest pain and fever. He was also hypoxic with oxygen saturation of 86% on room air. Detailed clinical history revealed that he had fatigue, dyspnea, night sweats, generalized bone pain and a loss of about 10 kg in weight over the past six months without intention. Chest imaging showed diffuse bilateral infiltrates. Diagnostic bronchoscopy was performed. Transbronchial biopsy and bronchoalveolar lavage were received simultaneously. The presence of P. jirovecii was suspected in hematoxylin-eosin-stained slides, and Gomori�s methenamine silver stain was used to confirm the diagnosis. A blood test revealed dyslipidemia, hypothyroidism, increased plasma levels of the gonadotropins and positive HIV antibodies with a CD4+ cell count of 48/μL. CMV co-infection was found with CMV viral load of 6738 copies/ml in plasma. Herein, we present a case with Pneumocystis jirovecii pneumonia (PCP) that led to a new diagnosis of Human immonudeficiency virus. As in our case, diagnosis of disease through the pathological examination of tissues (biopsy samples) or bodily fluids could lead to the recognition of an unrevealed HIV-infection.
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spelling doaj.art-b94af8145a074bb8b2216788575f42ee2023-02-15T16:07:56ZengFederation of Turkish Pathology SocietiesTürk Patoloji Dergisi1018-56151309-57302020-09-0136324625010.5146/tjpath.2020.01480Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case ReportSelin KESTEL KAYIKElif ACARLeyla MEMİŞPneumocystis jirovecii is a potentially life-threatening opportunistic pathogen particularly affecting the lungs, mainly in immunosuppressed individuals and HIV-infected patients with a low CD4 cell count. A 50-year-old man presented with a 1-week history of pleuritic chest pain and fever. He was also hypoxic with oxygen saturation of 86% on room air. Detailed clinical history revealed that he had fatigue, dyspnea, night sweats, generalized bone pain and a loss of about 10 kg in weight over the past six months without intention. Chest imaging showed diffuse bilateral infiltrates. Diagnostic bronchoscopy was performed. Transbronchial biopsy and bronchoalveolar lavage were received simultaneously. The presence of P. jirovecii was suspected in hematoxylin-eosin-stained slides, and Gomori�s methenamine silver stain was used to confirm the diagnosis. A blood test revealed dyslipidemia, hypothyroidism, increased plasma levels of the gonadotropins and positive HIV antibodies with a CD4+ cell count of 48/μL. CMV co-infection was found with CMV viral load of 6738 copies/ml in plasma. Herein, we present a case with Pneumocystis jirovecii pneumonia (PCP) that led to a new diagnosis of Human immonudeficiency virus. As in our case, diagnosis of disease through the pathological examination of tissues (biopsy samples) or bodily fluids could lead to the recognition of an unrevealed HIV-infection. http://www.turkjpath.org/pdf.php3?id=1917 acquired immunodeficiency syndromepneumocystis pneumoniahiv
spellingShingle Selin KESTEL KAYIK
Elif ACAR
Leyla MEMİŞ
Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
Türk Patoloji Dergisi
acquired immunodeficiency syndrome
pneumocystis pneumonia
hiv
title Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
title_full Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
title_fullStr Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
title_full_unstemmed Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
title_short Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report
title_sort pneumocystis jirovecii pneumonia in newly diagnosed hiv infection a challenging case report
topic acquired immunodeficiency syndrome
pneumocystis pneumonia
hiv
url http://www.turkjpath.org/pdf.php3?id=1917
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AT elifacar pneumocystisjiroveciipneumoniainnewlydiagnosedhivinfectionachallengingcasereport
AT leylamemis pneumocystisjiroveciipneumoniainnewlydiagnosedhivinfectionachallengingcasereport