CTICasesPneumocystis jirovecii Pneumonia (PJP)
Imaging findings
Serial chest radiographs demonstrate rapidly progressive, diffuse, bilateral hazy ground-glass opacities. CT chest shows diffuse ground-glass attenuation on a background of emphysema, with areas of organizing pneumonia demonstrating a perilobular, arcading appearance, and several small nodular opacities.
Key takeaways
Pneumocystis jirovecii pneumonia is an opportunistic fungal infection that can occur in non-HIV oncology patients, particularly those undergoing corticosteroid therapy. This patient was receiving a steroid taper for brain metastases in the setting of lung cancer, which induced severe lymphopenia, predisposed him to PJP, and highlighted that corticosteroid use is a significant independent risk factor for PJP in solid tumor patients.
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