Pneumocystis jirovecii pneumonia radiology

DEFINITION
Opportunistic fungal infection that affects individuals with T-cell immunodeficiency

IMAGING
– Radiograph
○ Normal, diffuse bilateral heterogeneous opacities
○ Spontaneous pneumothorax in HIV(+) patient is nearly diagnostic of PCP
– CT
○ Ground-glass opacities are dominant finding
➜ Most commonly central with relative subpleural sparing (41%)
➜ Heterogeneous with mosaic attenuation (29%), or diffuse (24%)
○ Crazy-paving pattern, less common
○ Variable-sized cysts, variable wall thickness
○ Atypical patterns: Multiple small nodules, lobar consolidation, masses
○ Lymphadenopathy uncommon (10%)
○ Pleural effusion rare

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