title: [Two cases of AIDS diagnosed by onset of interstitial pneumonia].
abstract: Case 1: A 35-year-old man admitted for fever and respiratory failure during several weeks was found in chest computed tomography (CT) to have interstitial pneumonia, and the plasma beta-D-glucan level indicated Pneumocystis jiverocii pneumonia. Psoriasis from second-stage syphilis raised the suspicion of HIV infection. Serum anti-HIV-1 antibody proved positive and CD4-positive lymphocytes in peripheral blood were 18/microL. The man died despite treatment. Autopsy confirmed P. jiverocii pneumonia. Case 2: A 28-year-old man seen for a fever and respiratory failure was found in chest CT to have mild interstitial pneumonia. We checked for hypersensitivity pneumonitis, Mycoplasma pneumoniae pneumonia, etc. The plasma beta-D-glucan level indicated possible P. jirovecii pneumonia and immunodeficiency. Serum anti-HIV-1 antibody proved positive and CD4-positive lymphocytes in peripheral blood were 34/microL. The man was treated successfully, using trimethoprim with sulfamethoxazole for his interstitial pneumonia. His clinical symptoms were compatible with P. jirovecii pneumonia. P. jirovecii pneumonia with AIDS may present with more subacute or subtle symptoms than other immunosuppressive diseases, making it difficult to diagnose. Medical professionals should thus make it a point to familiarize themselves with AIDS prevention.
authors.affiliation: Department of Respiratory and Allergy Medicine, Kinki University of Medicine, Nara Hospital.
authors.forename: Hirochiyo
authors.initials: H
authors.lastname: Sawaguchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nakajima
authors.forename: Sigenori
authors.initials: S
authors.lastname: Nakajima
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Konishi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D015483:HIV Antibodies / Q000276:immunology; D006716:Homosexuality; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D015483:HIV Antibodies