Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Pneumocystis Pneumonia Mimicking Acute Eosinophilic Pneumonia in a Patient with AIDS

후천성면역결핍증후군 환자에게 급성 호산구성 폐렴 양상을 보인 폐포자충 폐렴 1예

  • Lee, Bo-Ra (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Kim, Hyun-Kook (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Park, I-Nae (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Choi, Sang-Bong (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Jung, Hoon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyun-Kyung (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sung-Soon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Young-Min (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Lee, Hyuk-Pyo (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Choi, Soo-Jeon (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Yum, Ho-Kee (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine)
  • 이보라 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 김현국 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 박이내 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 최상봉 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 정훈 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이현경 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이성순 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이영민 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 이혁표 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 최수전 (인제대학교 의과대학 서울백병원 내과학교실) ;
  • 염호기 (인제대학교 의과대학 서울백병원 내과학교실)
  • Received : 2009.10.09
  • Accepted : 2009.12.15
  • Published : 2010.02.28
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Abstract

A 73-year-old man was admitted with a sudden onset of dyspnea. He had never smoked. The chest radiograph and computed tomography revealed bilateral ground glass opacity and an enlarging perihilar consolidation with lymphadenopathies. There was a higher percentage of eosinophils (72%) in the bronchoalveolar lavage fluid (BALF) than normal. The patient was diagnosed with acute eosinophilic pneumonia and managed with steroid. Pneumocystis pneumonia (PCP) was diagnosed by an examination of the BALF, and the patient was treated with trimethoprim-sulphamethoxazole. The patient tested positive to the HIV antibody and the peripheral blood CD-4 positive lymphocyte count was only $33/{\mu}L$. The percentage of eosinophils in the BALF can increase in some cases of PCP that is complicated with AIDS. Only a few cases of eosinophilic pneumonia associated with PCP pneumonia have been reported in patients with AIDS but there are no case reports in Korea. This case highlights the need to consider PCP when the percentage of eosinophils in the BALF is elevated.

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References

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