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KMID : 0311120160570041042
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Yonsei Medical Journal
2016 Volume.57 No. 4 p.1042 ~ p.1046
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Unmasking Granulomatous Pneumocystis jirovecii Pneumonia with Nodular Opacity in an HIV-Infected Patient after Initiation of Antiretroviral Therapy
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Kim Hyung-Woo
Heo Jung-Yeon
Lee Yong-Moon
Kim S-J
Jeong Hye-Won
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Abstract
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Pneumocystis jirovecii pneumonia (PJP) in patients with HIV infection can, in rare cases, present with pulmonary nodules that histologically involve granulomatous inflammation. This report describes an intriguing case of granulomatous PJP with pulmonary nodules after commencing antiretroviral therapy (ART) in an HIV-infected patient without respiratory signs or symptoms. Diagnosis of granulomatous PJP was only achieved through thoracoscopic lung biopsy. This case suggests that granulomatous PJP should be considered in the differential diagnosis of pulmonary nodules in HIV-infected patients for unmasking immune reconstitution inflammatory syndrome manifestation after initiation of ART.
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KEYWORD
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Pneumocystis pneumonia, HIV infections, immune reconstitution inflammatory syndrome
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