[Granulomatous pneumocystis pneumonia].
BACKGROUND
Granulomatous pneumocystis pneumonia (PCP) is a rarity whose presentation may be misleading.


METHODS
We report the case of a patient suffering from chronic lymphatic leukaemia presenting with acute respiratory insufficiency, with a fatal outcome, due to granulomatous PCP. Broncho-alveolar lavage (BAL) remained negative and the diagnosis could only be made later by open lung biopsy.


CONCLUSIONS
Although infrequent, granulomatous PCP should be recognised because in this situation the standard investigation (BAL) may be negative. New, more sensitive, methods of investigation such as the polymerase chain reaction (PCR) may permit earlier diagnosis.
Pontier
S
S
Service de Pneumo-allergologie, CHU Purpan, 1 place Baylac, 31059 Toulouse Cedex, France. pontier_sandrine@yahoo.fr
Busato
F
F
Daste
G
G
Genestal
M
M
Recco
P
P
Nevez
G
G
Escamilla
R
R
D001706:Biopsy; D018893:Bronchoalveolar Lavage; D017809:Fatal Outcome; D006099:Granuloma / Q000150:complications* / Q000473:pathology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008168:Lung / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000473:pathology; D012131:Respiratory Insufficiency / Q000209:etiology