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Pneumocystis pneumonia (PCP) is an atypical pulmonary infection and the most common opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). https://radiopaedia.org/articles/pneumocystis-pneumonia

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Pneumocystis pneumonia: Presentation:HIV+ male with cough and shortness or breath. There is hazy, predominantly perihilar mid and upper zone opacification with some interstitial prominence. A few discrete cysts (pneumatocoeles) measuring up to 1cm can be seen. No pleural effusion. No obvious nodal enlargement.

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:Pneumocystis carinii pneumonia. Chest X-ray shows atypical features of upper lobe focal reticulation associated with minor ground-glass appearance

:Pneumocystis carinii pneumonia. Pneumothoraces are often refractory to conventional chest tube drainage, becoming chronic, requiring pleurodesis or surgical intervention as in this patient

:Pneumocystis carinii pneumonia. Chest X-ray (R) shows a thin-walled cyst in the right upper lobe (arrow). The left image shows multiple cysts in the apical regions related to pentamidine inhalation in a human immunodeficiency virus patient

:Pneumocystis carinii pneumonia atypical features. Chest X-ray shows diffuse, vague, ill-defined lung nodules associated with a right-sided pleural effusion (confirmed by ultrasound)

Robert Morris - MOMORIA (For Alan Buchsbaum, dead March 21, 1986, from Pneumocystis Carinii Pneumonia), 1986 , lead, silver leaf, acids, graphite, lacquer , 76 x 65.5 x 1.5 inches

Figure 2. Chest radiograph of an HIV positive person with a CD4 cell count below 200 cells/mm3, demonstrating the characteristic bilateral granular opacities of PCP. Bronchoscopy with bronchoalveolar lavage fluid microscopic examination revealed Pneumocystis cysts and trophic forms. Courtesy of Laurence Huang, MD.