Respiratory distress, pneumonic changes on chest X-ray, hypoxaemia, oral candidiasis in a homosexual male: not always Pneumocystis carinii pneumonia.
A young homosexual male presented to the emergency department with respiratory distress, oropharyngeal candidiasis, hypoxaemia, and renal failure. Pneumocystis carinii pneumonia was considered to be the likely diagnosis - until 24 h later when the patient divulged the true history of paraquat ingestion some 5 days previously. Ingestion of corrosives should be considered in patients with oropharyngeal candidiasis and pneumonic symptoms, especially in the presence of renal failure as an alternative to HIV infection.
Twinem
Gillian
G
Ulster Hospital, Dundonald, Belfast, Northern Ireland, UK.
Monaghan
Darren
D
McGovern
Sean
S