{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T22:39:33Z","timestamp":1762641573347,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Primary HIV infection can occur in 40\u201390% of individuals recently infected with HIV. Variable symptoms usually suggestive of a flu-like illness as well as high-level HIV viraemia and steep decline in CD4 cell count are often noted. We report a case of a previously healthy homosexual man who presented with symptoms suspicious of primary HIV infection as well as non-productive cough associated with chest CT finding of diffuse ground glass appearance in lungs. Recent HIV seroconversion was confirmed. Diagnosis of <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia was made on transbronchial lung biopsy. The symptoms improved rapidly after initiation of treatment with trimethoprim-sulfamethoxazole. It is important to recognise that although <jats:italic>Pneumocystis<\/jats:italic> pneumonia is generally seen in the setting of AIDS, it can occasionally also occur during primary HIV infection.<\/jats:p>","DOI":"10.1136\/bcr-2013-009612","type":"journal-article","created":{"date-parts":[[2013,6,17]],"date-time":"2013-06-17T03:24:11Z","timestamp":1371439451000},"page":"bcr2013009612","source":"Crossref","is-referenced-by-count":2,"title":["Never too early for the opportunists!"],"prefix":"10.1136","volume":"2013","author":[{"given":"Anup","family":"Subedee","sequence":"first","affiliation":[{"name":"Department of Medicine, Infectious Diseases Section, Tulane University School of Medicine, New Orleans, Louisiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Kimmel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Reading Health System, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony A","family":"Donato","sequence":"additional","affiliation":[{"name":"Department of IM, Reading Health System, West Reading, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,6,17]]},"reference":[{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S0140-6736(85)91205-X","article-title":"Acute AIDS retrovirus infection: definition of a clinical illness associated with seroconversion","volume":"2013","author":"Cooper","year":"1985","journal-title":"Lancet"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.2","unstructured":"USA. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. [Updated 12 February 2013]. http:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/AdultandAdolescentGL.pdf (accessed 18 May 2013)."},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.3","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/00126334-200211010-00007","article-title":"Clinical features of acute retroviral syndrome differ by route of infection but not by gender and age","volume":"2013","author":"Vanhems","year":"2002","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.7326\/0003-4819-134-1-200101020-00010","article-title":"Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network","volume":"2013","author":"Daar","year":"2001","journal-title":"Ann Intern Med"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.5","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jviromet.2004.08.018","article-title":"Evaluation of the sensitivity and specificity of six HIV combined p24 antigen and antibody assays","volume":"2013","author":"Ly","year":"2004","journal-title":"J Virol Methods"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.6","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1038\/nature03501","article-title":"Massive infection and loss of memory CD4+ T cells in multiple tissues during acute SIV infection","volume":"2013","author":"Mattapallil","year":"2005","journal-title":"Nature"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.7","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/0140-6736(93)91884-O","article-title":"Pneumocystis carinii pneumonia during primary HIV-1 infection","volume":"2013","author":"Vento","year":"1993","journal-title":"Lancet"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.8","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1097\/00002030-198911000-00010","article-title":"Severe clinical manifestations of primary HIV infection","volume":"2013","author":"Tindall","year":"1989","journal-title":"AIDS"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.9","first-page":"313","article-title":"Unusual case of Pneumocystis jiroveci pneumonia during primary HIV infection","volume":"2013","author":"Byers","year":"2008","journal-title":"Aids Read"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.10","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1758-2652-14-40","article-title":"Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters","volume":"2013","author":"Socias","year":"2011","journal-title":"J Int AIDS Soc"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1089\/10872910260066688","article-title":"Unusual presentations of primary human immunodeficiency virus infection","volume":"2013","author":"Szabo","year":"2002","journal-title":"AIDS Patient Care STDS"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.12","doi-asserted-by":"crossref","first-page":"273","DOI":"10.2174\/157016207780077011","article-title":"Fatal disseminated toxoplasmosis during primary HIV infection","volume":"2013","author":"Signorini","year":"2007","journal-title":"Curr HIV Res"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.13","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1056\/NEJMoa1110187","article-title":"Enhanced CD4+ T-cell recovery with earlier HIV-1 antiretroviral therapy","volume":"2013","author":"Le","year":"2013","journal-title":"N Engl J Med"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.14","first-page":"207","article-title":"Short-course antiretroviral therapy in primary HIV infection","volume":"2013","author":"Fidler","year":"2013","journal-title":"N Engl J Med"},{"key":"2025082802255671000_2013.jun16_1.bcr2013009612.15","unstructured":"USA. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. [Updated 7 May 2013]. http:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/adult_oi.pdf (accessed 18 May 2013)."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-009612","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:26:07Z","timestamp":1756373167000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-009612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,17]]},"references-count":15,"alternative-id":["10.1136\/bcr-2013-009612"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-009612","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,6,17]]}}}