For those who picked up on the "clear lungs" with all the ground-glass we also suspected PCP in this young man with no other Hx of structural lung Dz. He was admitted at night so we started him on IV bactrim and steroids (and a 3 rd gen Cef), ordered a rapid HIV test and planned on doing a bronch. His HIV was positive and then they volunteered his partner was HIV+ and requested a transfer to a University Hospital here in TN. His PCP DNA PCR was positive, his CD4 was around 50 and overall he did very well. Here is his follow-up CxR:
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