American Journal of Medical Case Reports
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American Journal of Medical Case Reports. 2022, 10(1), 13-16
DOI: 10.12691/ajmcr-10-1-5
Open AccessCase Report

Pulmonary Pneumocystosis in a Patient with a CD4-Lymphocyte Count Greater than 200 cells/μL

Louis Costanzo1, , Steffi Nainan1, Vladimir Falb1 and Davood Johari2

1Department of Internal Medicine, State University of New York, Downstate- Health Science University, Brooklyn, NY, USA – 11203

2Division of Pulmonology and Critical Care Medicine, Kings County Hospital Center, Brooklyn, NY, USA - 11203

Pub. Date: December 19, 2021

Cite this paper:
Louis Costanzo, Steffi Nainan, Vladimir Falb and Davood Johari. Pulmonary Pneumocystosis in a Patient with a CD4-Lymphocyte Count Greater than 200 cells/μL. American Journal of Medical Case Reports. 2022; 10(1):13-16. doi: 10.12691/ajmcr-10-1-5


A 47-year-old man, who has no past medical history, presented to the hospital with shortness of breath. He was found to have HIV with a CD4 count of nearly 300 cells/μL, elevated LDH, and a chest x-ray depicting multifocal pneumonia with ground glass opacities. He was admitted to the intensive care unit and ultimately diagnosed with pneumocystis pneumonia status post bronchoscopy; making PCP his first AIDS-defining event. While PCP usually occurs when individual CD4 counts are <200 cells/μL, approximately 10% of cases occur in patients with higher counts.

acute dyspnea human immunodeficiency virus pneumocystosis pneumonia

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[1]  Walzer PD. Attachment of microbes to host cells: relevance of Pneumocystis carinii. Lab Invest. 1986 Jun; 54(6): 589-92. PMID: 2423776.
[2]  Pahal P, Rajasurya V, Sharma S. Typical Bacterial Pneumonia. [Updated 2021 Jul 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:
[3]  Gigliotti F, Limper AH, Wright T. Pneumocystis. Cold Spring Harb Perspect Med. 2014; 4(12): a019828. Published 2014 Nov 3.
[4]  Li WJ, Guo YL, Liu TJ, Wang K, Kong JL. Diagnosis of pneumocystis pneumonia using serum (1-3)-β-D-Glucan: a bivariate meta-analysis and systematic review. J Thorac Dis. 2015; 7(12): 2214-2225.
[5]  Crans CA Jr, Boiselle PM. Imaging features of Pneumocystis carinii pneumonia. Crit Rev Diagn Imaging. 1999 Aug; 40(4): 251-84.
[6]  Diamond M, Peniston Feliciano HL, Sanghavi D, et al. Acute Respiratory Distress Syndrome. [Updated 2021 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:
[7]  Welker C, Huang J, Gil IJN, Ramakrishna H. 2021 Acute Respiratory Distress Syndrome Update, With Coronavirus Disease 2019 Focus [published online ahead of print, 2021 Feb 27]. J Cardiothorac Vasc Anesth. 2021; S1053-0770(21)00188-9.
[8]  Agarwal R, Aggarwal AN, Gupta D. (2010). Role of noninvasive ventilation in acute lung injury/acute respiratory distress syndrome: a proportion meta-analysis. Respir Care 55:1653-1660.
[9]  Golden JA, Hollander H, Stulbarg MS, Gamsu G. Bronchoalveolar lavage as the exclusive diagnostic modality for Pneumocystis carinii pneumonia. A prospective study among patients with acquired immunodeficiency syndrome. Chest. 1986 Jul; 90(1): 18-22.
[10]  Briel M, Bucher HC, Boscacci R, Furrer H. Adjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV-infection. Cochrane Database Syst Rev. 2006 Jul 19; (3): CD006150. Update in: Cochrane Database Syst Rev. 2015; 4: CD006150. PMID: 16856118.