title: Reversed halo sign in pneumocystis pneumonia: a case report.
abstract: BACKGROUND
  The reversed halo sign may sometimes be seen in patients with cryptogenic organizing pneumonia, but is rarely associated with other diseases.
  
  
  METHODS
  We present a case study of a 32-year-old male patient with acquired immunodeficiency syndrome, who had previously been treated with chemotherapy for non-Hodgkin's lymphoma. A chest X-ray showed bilateral patchy infiltrates. High-resolution computed tomography revealed the reversed halo sign in both upper lobes. The patient was diagnosed with pneumocystis pneumonia, which was successfully treated with sulfamethoxazole trimethoprim; the reversed halo sign disappeared, leaving cystic lesions. Cases such as this one are rare, but show that the reversed halo sign may occur in patients who do not have cryptogenic organizing pneumonia.
  
  
  CONCLUSIONS
  Physicians can avoid making an incorrect diagnosis and prescribing the wrong treatment by carefully evaluating all clinical criteria rather than assuming that the reversed halo sign only occurs with cryptogenic organizing pneumonia.
authors.affiliation: Department of Respiratory Medicine, Nishi-Kobe Medical Center, Kojidai, Nishi-ku, Kobe, Japan. h.ohtera@nmc-kobe.org
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otera
authors.forename: Kimihide
authors.initials: K
authors.lastname: Tada
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Kimio
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic