Pneumocystis jirovecii (Pneumocystis pneumonia)

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Summary of Pneumocystis jirovecii (Pneumocystis pneumonia)

Pneumocystis jirovecii is a yeast-like fungus of the genus Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts like those with AIDS. TMP-SMX, atovaquone, and pentamidine are used for both prophylaxis and treatment for this fungus, while dapsone is used only for prophylaxis.

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Pneumocystis jirovecii (Pneumocystis pneumonia)

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Pneumocystis jirovecii (Pneumocystis pneumonia)

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A 58-year-old man goes to the emergency department for evaluation of fever and dry cough for the past week. He has also become progressively more dyspneic, and walking a single block makes him short of breath. He underwent a liver transplantation 4-months ago for treatment of autoimmune hepatitis and is currently taking several immunosuppressant drugs. Temperature is 38.5°C (101.3°F), pulse is 104/min, respirations are 20/min, blood pressure is 122/88 mmHg, and oxygen saturation is 89% on room air. Lung auscultation reveals bilateral crackles and rhonchi. Chest radiograph reveals bilateral, diffuse interstitial infiltrates extending from the perihilar region. Leukocyte count is 13,000/mm3 and serum lactate dehydrogenase level is 460 U/L. Further testing is most likely to reveal which of the following findings?

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