Question

28 year-old cachectic female presents in respiratory distress and is immediately intubated on arrival to Emergency Department. What's the diagnosis and what are some potential etiologies?

Answer

Pneumothorax with mediastinal shift

Differential Diagnosis

• Atypical bacterial PNA
• Acute Respiratory Distress Syndrome
• Interstitial lung disease
• Pneumocystis Jirovecii PNA (PJP)

The patient in this case had undiagnosed HIV/AIDS and presented with PTX secondary to PJP. The lifetime risk of PTX with HIV is 6% and 85% of those cases are secondary to PJP.

References

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