Case history
Case history #1
A 34-year-old man with a history of sex with men presents with 3 weeks of worsening dyspnoea associated with fevers and a non-productive cough. He is tachycardic and tachypnoeic, and has a temperature of 38.1°C (100.5°F). His pulse oximetry is 86% on room air. He appears thin and in moderate respiratory distress. His lung examination is unremarkable.
Case history #2
A 45-year-old woman with a history of granulomatosis with polyangiitis, treated for 6 months with cyclophosphamide and prednisolone, presents with 1 week of cough, shortness of breath, and fevers. She is tachypnoeic and has a pulse oximetry of 80% on room air. She is in a moderate amount of respiratory distress and has some diffuse rales in her lungs.
Other presentations
Patients with severely advanced HIV disease, particularly with use of aerosolised pentamidine prophylaxis, can present occasionally with extrapulmonary manifestations of Pneumocystis pneumonia, involving, most frequently, the lymph nodes, spleen, liver, and bone marrow.
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