title: [Granulomatous pneumocystis pneumonia].
abstract: 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.
authors.affiliation: Service de Pneumo-allergologie, CHU Purpan, 1 place Baylac, 31059 Toulouse Cedex, France. pontier_sandrine@yahoo.fr
authors.forename: S
authors.initials: S
authors.lastname: Pontier
authors.forename: F
authors.initials: F
authors.lastname: Busato
authors.forename: G
authors.initials: G
authors.lastname: Daste
authors.forename: M
authors.initials: M
authors.lastname: Genestal
authors.forename: P
authors.initials: P
authors.lastname: Recco
authors.forename: G
authors.initials: G
authors.lastname: Nevez
authors.forename: R
authors.initials: R
authors.lastname: Escamilla
mesh_terms: 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