Pneumocystis jirovecii Pneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/ μ L and Atovaquone Prophylaxis
Document Type
Article
Publication Date
1-1-2020
Abstract
We describe a rare case of Pneumocystis jirovecii pneumonia (PCP) in a heterosexual man with a pertinent medical history of well-controlled human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) and PCP prophylaxis with atovaquone. The patient presented with recurrent shortness of breath, worsening malaise, and fever, following treatment for hypersensitivity pneumonitis one month prior, including a twenty-four-day course of 40 milligrams daily glucocorticoid with taper. However, transbronchial biopsies, lavage, and cytology from prior admission were inconclusive. The patient refused video-assisted thoracic surgery (VATS) at that time. Upon readmission, bronchoscopy with right VATS and lung biopsy were performed. Grocott's methenamine silver stain of right lung biopsy was positive for Pneumocystis jirovecii. This case is a rare example of PCP in a patient with a normal CD4 count (>487 cells/μL) and a low viral load (/mL) despite PCP prophylactic antibiotics in the setting of recent iatrogenic immunosuppression.
Publication Title
Case Rep Infect Dis
Volume
2020
First Page
8532780
Last Page
8532780
Recommended Citation
Sullivan, A., Lanham, T., Krol, R., & Zachariah, S. (2020). Pneumocystis jirovecii Pneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/ μ L and Atovaquone Prophylaxis. Case Rep Infect Dis, 2020, 8532780-8532780. Retrieved from https://scholarcommons.towerhealth.org/gme_int_med_resident_program_read/573