Discover and read the best of Twitter Threads about #Pneumocystis

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Images of Infectious Diseases
58M. NYC. No PMH.

1 mo ago: high dose prednisone, rituximab, plasma exchange for presumed paraneoplastic autoimmune polyneuropathy.

Now: PET-CT. Biopsy (shown)

ROS: fever, cough, chest pain
What is the DDx? Case details #MayoIDQ to follow… Image
2/
No travel. No farm exposure. No pets.
Work up:
CXR RML opacity
WBC 13.7. 94%N.
HIV neg.
Galactomannan negative
Histoplasma serology negative
BDG >500
What is the most likely pathogen? #MayoIDQ
3/
Case diagnosis: #Pneumocystis jirovecii pneumonia presenting as solitary granulomatous inflammatory nodule

BAL PJP smear / PCR negative
Biopsy: PJP

Repeated PCR of stored BALF: low +
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