What is the role of radiography in the diagnosis of Pneumocystis jiroveci pneumonia (PJP)?

Updated: Apr 24, 2019
  • Author: Shelley A Gilroy, MD, FACP, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Answer

Chest radiography should be obtained in any immunocompromised patient with fever and/or respiratory signs or symptoms. [28] The chest radiographic findings may be normal in patients with early mild disease. Diffuse bilateral infiltrates extending from the perihilar region are visible in most patients with P jiroveci pneumonia (PJP). Less-common findings include patchy asymmetric infiltrates, pneumothorax, and pneumatoceles. A radiographically normal chest radiograph has also been described. Pleural effusions and intrathoracic adenopathy are rare.

Pneumothorax may also develop in patients using aerosolized pentamidine. Apical disease may also be found in patients using aerosolized pentamidine for prophylaxis, as shown in the image below.

Chest radiograph demonstrating diffuse bilateral i Chest radiograph demonstrating diffuse bilateral infiltrates in a patient with Pneumocystis jiroveci pneumonia.

Go to Imaging Pneumocystis Carinii Pneumonia for complete information on this topic.


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