Final answer:
In an immunocompromised patient with CT chest findings of pulmonary nodules and surrounding ground-glass opacities, differential diagnoses include fungal infections like Pneumocystis pneumonia (PCP), tuberculosis (TB), and aspergillosis. Fungal infections like PCP are treated with TMP/SMZ, while TB and aspergillosis require different management.
Step-by-step explanation:
Pulmonary Infections in Immunocompromised Patients
When an immunocompromised patient presents with CT chest findings of pulmonary nodules and surrounding ground-glass opacities, several infectious etiologies must be considered. These can include, but are not limited to, fungal infections, tuberculosis (TB), Pneumocystis pneumonia (PCP), and aspergillosis. Each of these conditions has unique clinical presentations, diagnostic findings, and treatment strategies.
Fungal infections such as PCP, caused by Pneumocystis jirovecii, can lead to severe pneumonia especially in patients with AIDS. Ground-glass opacities and pneumatoceles on imaging are characteristic findings. The treatment of choice is trimethoprim-sulfamethoxazole (TMP/SMZ).
Tuberculosis and other mycobacterial infections also present with pulmonary nodules. TB can form calcified Ghon complexes and requires different antibiotics. Aspergillosis, which could lead to structures known as fungal balls, is another differential diagnosis.