CTICasesPneumocystis jirovecii Pneumonia (PJP) and Cryptococcosis in AIDS
Imaging findings
Initial radiographs are subtly abnormal with multifocal, ill-defined opacities. Subsequent radiographs show a diffuse process with confluent, polymorphous opacities throughout the lungs. CT reveals multifocal, multilobar, confluent geographic ground-glass opacity, somewhat asymmetric, with one single cavitated nodule. Hilar lymphadenopathy is also present.
Key takeaways
In an immunocompromised patient, particularly with newly diagnosed AIDS and lymphopenia, diffuse ground-glass opacities are classic for Pneumocystis jirovecii Pneumonia (PJP). Co-infections with other opportunistic pathogens, such as Cryptococcus (diagnosed by positive serum and CSF antigen in this case presenting with meningitis), are common. The presence of a solitary cavitated nodule with Cryptococcosis is an unusual manifestation. Other opportunistic infections like Kaposi sarcoma may also be present.
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