Atypical Radiographic Presentation of Pneumonia in a Newly Diagnosed HIV Patient.

Journal: Case reports in infectious diseases

Volume: 2019

Issue: 

Year of Publication: 

Affiliated Institutions:  Division of Pulmonary and Critical Care Medicine, Bronx Care Health System, Icahn School of Medicine at Mount Sinai, Grand Concourse, Bronx, NY , USA. Department of Medicine, Bronx Care Health System, Icahn School of Medicine at Mount Sinai, Grand Concourse, Bronx, NY , USA. Division of Pathology, Bronx Care Health System, Icahn School of Medicine at Mount Sinai, Grand Concourse, Bronx, NY , USA.

Abstract summary 

infection is an opportunistic infection that occurs primarily among immunocompromised patients, and the morbidity and mortality of this infection is high if left unrecognized and untreated. There are no clinical or radiographic characteristics typical of cryptococcal pneumonia, and its clinical and radiological presentations often overlap with other diagnoses.We present a case of a 25-year-old man from Ghana admitted for an altered mental state, weight loss, neck pain, fever, and photophobia. He was diagnosed with meningitis by cerebrospinal fluid culture and with disseminated cryptococcal infection by a positive blood test. Diffuse micronodular opacities were found in a miliary pattern in the upper portions of both lungs upon imaging, which suggested miliary tuberculosis; thus, the patient was started on antituberculosis therapy. The patient underwent flexible fiber optic bronchoscopy, and transbronchial biopsy of the right lung showed bronchopneumonia with fungal spores consistent with filamentous , which grew in tissue culture of the right lung. Interferon-gamma release assay, PCR, and acid-fast bacilli staining of the bronchoalveolar lavage were negative for the complex.The similarities in clinical and imaging findings among patients with acute immunodeficiency syndrome with coinfections make diagnoses difficult; thus image-guided biopsies are essential to confirm diagnoses.

Authors & Co-authors:  Cacacho Arthur A Ashraf Umair U Rehmani Arsalan A Niazi Masooma M Khaja Misbahuddin M

Study Outcome 

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Citations :  McCarthy K. M., Morgan J., Wannemuehler K. A., et al. Population-based surveillance for cryptococcosis in an antiretroviral-naive South African province with a high HIV seroprevalence. AIDS. 2006;20(17):2199–2206. doi: 10.1097/qad.0b013e3280106d6a.
Authors :  5
Identifiers
Doi : 9032958
SSN : 2090-6625
Study Population
Man
Mesh Terms
Other Terms
Study Design
Case Study,Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
Egypt