[Quiz] A HIV patient who has progressive dyspnoea and non-productive cough

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A HIV patient admitted to your ward with complaints of progressive dyspnoea and non-productive cough.

Upon questioning, you found out that he has exertional dypsnoea too. A CXR was done and shown as above :

1. Describe the findings in the CXR.
2. What is your preliminary diagnosis based on clinical presentation and CXR?
3. Which other methods are required to confirm the diagnosis you mentioned in Q2?

Answers will be provided on 20th April 2010.

Answer [click to expand]

1. What can you see in the CXR ?
White shadowing in perihilar region
Fine reticular interstitial pattern,which typical doesn’t extend to the apices or costophrenic angles.

2. What is your preliminary diagnosis based on clinical presentation and CXR?
PCP( PneumoCystis Pneumonia)

3. Which diagnosis is required for diagnosis ?
Sputum examination after inhalation of hypertonic saline solution
Bronchoalveolar Lavage(BAL)


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