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X-ray: Pneumocystis Pneumonia

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X-ray: Pneumocystis Pneumonia

  1. 1. Imaging of the week<br />Dr.Anirudh J Shetty<br />PROF.DR.DHANDAPANI’S UNIT <br />
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  5. 5. 34 yr old unmarried male ,c/o<br /> fever without chills –2 days;<br /> breathlessness & hemoptysis-1 day;<br />h/o non productive cough +<br />No h/o haematuria<br />No h/o chest pain /PND /orthopnea<br />Not a known DM/HT/TB/IHD/BA/ pt.<br />O/E<br />emaciated,thin ,dyspneic,tachypneic<br /> vitals-BP -110/80 mmHg<br /> CVS-S1 ,S2 heard<br /> RS- bil.BB + in infrascapular,mammary ,inframammary and infraaxillary areas bil.creps.+<br /> other systems- NAD<br />
  6. 6. SUMMARY;<br /> -CHEST X RAY PA VIEW<br /> -ADEQUATELY PENETRATED<br /> -INSPIRATORY FILM<br /> -PROPERLY CENTRED<br /> -TRACHEA IN THE MIDLINE<br /> -SOFT TISSUES & BONE NORMAL<br /> -HEART SHADOWS NORMAL<br />NON HOMOGENOUS OPACITIES SEEN BILATERALLY IN THE MID AND LOWER ZONES<br /> MORE ON THE LEFT SIDE <br />
  7. 7. DIFFERENTIAL DIAGNOSIS;<br />ACUTE ALVEOLAR LUNG DISEASE<br />“HEAP”<br />Hemorrhage -Wegener granulomatosisSystemic lupus erythematosusGoodpasture syndrome Other vasculitides (e.g., polyarteritis<br />nodosa, Henoch-Schönleinpurpura)<br /> Edema <br /> Alveolar proteinosis/Aspiration <br /> Pneumonia (includes infectious, organizing, and <br />eosinophilic pneumonias)<br />
  8. 8. Pneumocystis PNEUMONIA<br />RADIOLOGY;<br /> - bilateral diffuse opacities, perihilarinitially,with a lower zone predominance”ground glass “opacities<br /> -later air space consolidation pattern<br />ATYPICAL PRESENTATIONS<br /> -solitary/multiple ;solid /cavitory nodular opacities<br /> -cystic lung disease <br /> -enlarged noncalcified/calcifiedhilar/mediastinal nodes<br /> -pleural effusion<br /> -air filled cysts/pneumatoceles causing pneumothorax<br />
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  11. 11. CLINICAL FEATURES;<br />non specific<br />dyspnea,dry cough<br />minimal signs –few crackles,wheeze<br />unusual-asthma,hemoptysis,HPOA<br />PCP related pneumothorax-sudden dyspneain AIDS patients<br />
  12. 12. EXTRAPULMONARY PCP;<br /> Virtually every organ system can be affected<br />heart <br />thyroid<br />bonemarrow<br />brain <br />git<br />skin <br />other manifestations include otitis media and externa, sinusitis n splenomegaly<br />
  13. 13. Thank <br /> u <br />

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