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Tuberculosis & Respiratory Diseases

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Vol.67 No.2
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Pneumocystis jiroveci Pneumonia Mimicking Miliary Tuberculosis in a Kidney Transplanted Patient

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2009, v.67 no.2, pp.127-130
Ju Young Jung (University of Ulsan)
Kyoung Hoon Rhee (University of Ulsan)
Dong Hoe Koo (University of Ulsan)
I-Nae Park (University of Ulsan)

Ju, Y. J. , Kyoung, H. R. , Dong, H. K. , I-Nae, P. , & (2009). Pneumocystis jiroveci Pneumonia Mimicking Miliary Tuberculosis in a Kidney Transplanted Patient. Tuberculosis & Respiratory Diseases, 67(2), 127-130.
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Abstract

Bilateral interstitial infiltration in chest radiography, which may be fine granular, reticular or of ground glass opacity, is the typical radiographic findings of Pneumocystis jiroveci pneumonia. Recently, atypical radiographic features, including cystic lung disease, spontaneous pneumothorax or nodular opacity, have been reported intermittently in patients with P. jiroveci pneumonia. We report the case of a 29-year-old woman with a transplanted kidney whose simple chest radiography and HRCT scan showed numerous miliary nodules in both lungs, mimicking miliary tuberculosis (TB). Under the presumptive diagnosis of miliary TB, empirical anti-TB medication was started. However, Grocott methenamine silver nitrate staining of a transbronchial lung biopsy tissue revealed P. jiroveci infection without evidence of TB. These findings suggest that even in TB-endemic area other etiology such as P. jiroveci as well as M. tuberculosis should be considered as an etiology of miliary lung nodules in immunocompromised patients.

keywords
Pneumocystis carinii (Pneumocystis jiroveci), Kidney transplantation, Bronchoscopy, Tuberculosis, Miliary

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