title: [Coinfection with Pneumocystis jirovecii and Mycobacterium tuberculosis in a patient with AIDS: a first report in Japan].
abstract: A 24-year-old man was admitted with a 7-month history of non-productive cough, and recent onset of fever and progressive dyspnea. A chest X-ray film and computed tomography (CT) scan showed bilateral infiltrates that indicated pneumocystis pneumonia (PCP). A transbronchial lung biopsy specimen demonstrated Pneumocystis jirovecii infection on Grocott staining, and was positive for acid-fast bacilli without necrotizing granuloma, which indicated coinfection with both Pneumocystis jirovecii and Mycobacterium tuberculosis. A test for human immunodeficiency virus (HIV) infection was positive, and his CD4 + T-lymphocyte count was 92 cells per cubic millimeter. Chest CT findings and pathological findings.were atypical for active tuberculosis (TB). It is important that clinicians should be aware that HIV-infected patients may have concurrent pulmonary TB and PCP, because the diagnosis is difficult.
authors.affiliation: Division of Pulmonary Medicine, St. Luke's International Hospital.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Yamao
authors.forename: Torahiko
authors.initials: T
authors.lastname: Jint
authors.forename: Naoki
authors.initials: N
authors.lastname: Nishimura
authors.forename: Mieko
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Koyu
authors.initials: K
authors.lastname: Suzuki
authors.forename: Naohiko
authors.initials: N
authors.lastname: Chohnabayashi
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D006801:Humans; D008297:Male; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000150:complications*; D014397:Tuberculosis, Pulmonary / Q000150:complications*; D055815:Young Adult