Question

A 46yo male presents c/o a persistent cough. His X-ray is concerning for pneumonia. Routine screening reveals a positive PCR for HIV, and antibodies. His CD4⁺ count is 260. His sputum culture is positive for MAC. What is your diagnosis?

Answer 1

The diagnosis for the patient is Pneumocystis pneumonia (PCP), a type of pneumonia caused by the fungus P. jirovecii. It primarily affects immunocompromised individuals and can be diagnosed through microscopic examination of lung tissue and fluid samples. Treatment involves using a combination drug called trimethoprim-sulfamethoxazole (TMP/SMZ).

Step-by-step explanation:

The diagnosis for the patient in question is Pneumocystis pneumonia (PCP). PCP is a type of pneumonia caused by the fungus Pneumocystis jirovecii and primarily affects immunocompromised individuals, such as those with HIV/AIDS or undergoing chemotherapy. The symptoms of PCP include fever, cough, and shortness of breath, and it can be diagnosed through microscopic examination of tissue and fluid samples from the lungs.

In the case of this patient, his positive PCR for HIV, low CD4⁺ count, and presence of P. jirovecii in his sputum culture confirm the diagnosis of PCP.

The recommended treatment for PCP is the combination drug trimethoprim-sulfamethoxazole (TMP/SMZ). Left untreated, PCP infections are often fatal.