CTICasesPneumocystis Pneumonia (PCP) and Companion CMV Pneumonia
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Imaging findings
A chest radiograph shows slight to significant widening of the upper mediastinum. CT reveals relatively diffuse ground glass opacities, areas of septal thickening, and irregular reticulation throughout most of the lungs, extending through all lobes. The companion case of CMV pneumonia in a bilateral lung transplant patient also presents with diffuse bilateral airspace opacities, septal thickening, and a crazy paving appearance.
Key takeaways
This patient with Hodgkin lymphoma, on prednisone and chemotherapy, presented with Subacute cough and worsening shortness of breath. The CT findings were classic for Pneumocystis pneumonia, which was confirmed by bronchoscopy. The patient had not been taking their prescribed Bactrim prophylaxis. Suspect Pneumocystis pneumonia early, as it can be fatal if not treated promptly. CMV pneumonia can have a similar appearance.
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