26 Pneumocystis jiroveci Pneumonia A general discussion of Pneumocystis as a respiratory pathogen was given in Chapter 25. In patients with AIDS, onset of the disease is often more indolent than in immunosuppressed patients without AIDS. Fever, cough, and dyspnea are the usual symptoms bringing the patient to medical attention. The typical chest radiograph shows diffuse interstitial or alveolar infiltrates. Often the lung fields look hazy, a pattern that may be difficult to characterize specifically as either interstitial or alveolar and commonly described as looking like “ground glass” (see Fig. 25-3). However, atypical radiographic presentations are clearly recognized with documented Pneumocystis pneumonia, including even the finding of a normal chest radiograph. High-resolution computed tomographic (CT) scanning is particularly sensitive for demonstrating subtle changes associated with Pneumocystis pneumonia and generally shows abnormal results even in patients with a normal chest radiograph.
Pulmonary Complications in the Immunocompromised Host
Acquired Immunodeficiency Syndrome (AIDS)
Infectious Complications of AIDS