Massive Cavitation by Pneumocystis jirovecii in an Immunocompromised Patient

Cureus. 2022 May 26;14(5):e25354. doi: 10.7759/cureus.25354. eCollection 2022 May.

Abstract

Since the development of antiretroviral therapy (ART) and antibiotic prophylaxis, the incidence of opportunistic infections in human immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) has been drastically reduced. However, third-world countries remain a fertile ground for medication nonadherence and inappropriate patient follow-up. Here, we present the case of a 42-year-old male with a history of HIV who presented with worsening shortness of breath and atypical chest pain. A chest X-ray and chest computed tomography scan revealed a left parahilar cavitation measuring 86 mm in diameter. A percutaneous lung biopsy revealed Pneumocystis jirovecii. Appropriate antibiotics were started, and the patient's clinical status significantly improved. This case illustrates the devastating consequences of uncontrolled HIV-AIDS. ART and prophylactic antibiotics remain the cornerstone of treatment to ameliorate progressive lung damage in patients.

Keywords: aids; cavitation; hiv; lung cavitation; medication noncompliance; opportunist infections in hiv; pneumocystis jirovecii pneumonia; pulmonary cavitation.

Publication types

  • Case Reports