Case history
Case history #1
A 34-year-old man with a history of sex with men presents with 3 weeks of worsening dyspnea associated with fevers and a nonproductive cough. He is tachycardic and tachypneic, and has a temperature of 100.5°F (38.1°C). 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 prednisone, presents with 1 week of cough, shortness of breath, and fevers. She is tachypneic 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 aerosolized 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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