Cystic lung lesions revealing a Pneumocystis jirovecii and Aspergillus flavus co-infection in an HIV-infected patient

摘要

FiguresFigure 1Chest X-ray showing diffuse alveolo-interstitial infiltrates (A), and computed tomography (B and C) showing diffuse cystic lesions (asterisks) surrounded by ground-glass opacities (arrow), and sometimes with thicker walls, mimicking an ‘air crescent sign’ (arrowhead).An untreated, HIV-infected, 39-year-old woman presented with a dry cough of 1-month duration. The physical examination was normal. A chest X-ray showed diffuse alveolo-interstitial infiltrates predominantly in the lung apex (Figure 1A). A computed tomography (CT) scan disclosed diffuse cystic lesions surrounded by ground-glass opacities (Figure 1B, C). Some cavitary lesions presented thicker walls, mimicking an ‘air crescent sign’. The patient's CD4 count was 83 cells/μl and HIV viral load was 501?180 copies/ml.