{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:00Z","timestamp":1756339500940,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,6,15]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>\n                  <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia typically presents with diffuse bilateral infiltrates or ground-glass opacities. However, the radiographic pattern may be atypical. We report a case of a woman in her 40s who presented with multiple pulmonary masses and prolonged symptoms of non-productive cough, generalised weakness and fatigue. Serial chest CT performed prior to her presentation showed a large right lower lobe lung mass with multiple additional bilateral pulmonary nodules. Her workup revealed a new diagnosis of AIDS. Pathology of several CT-guided needle biopsies was consistent with <jats:italic>Pneumocystis<\/jats:italic> which was confirmed by microbial DNA sequencing. No additional pathogens were identified. Her clinical symptoms and radiographs improved significantly with trimethoprim-sulfamethoxazole and treatment of her HIV infection. Clinicians should evaluate for underlying immunodeficiency and seek infectious disease and pulmonary consultation early for consideration of alternative diagnoses when patients present with cough, dyspnoea and atypical chest radiographs, and initial pathological examination is unrevealing.<\/jats:p>","DOI":"10.1136\/bcr-2022-253563","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T13:55:18Z","timestamp":1690811718000},"page":"e253563","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Pneumocystis jirovecii<\/i> pneumonia presenting as a large pulmonary mass in a patient with AIDS"],"prefix":"10.1136","volume":"16","author":[{"given":"Taryn","family":"Bolling","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy Gurevitz","family":"Beal","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather K","family":"Caulkins","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3457-442X","authenticated-orcid":false,"given":"Gary P","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"key":"2025082708192516000_16.7.e253563.1","doi-asserted-by":"publisher","DOI":"10.1038\/334519a0"},{"key":"2025082708192516000_16.7.e253563.2","first-page":"120","article-title":"[Parasitic pneumonia. Interstitial plasma cell pneumonia of premature, caused by Pneumocystis Carinii]","volume":"158","author":"Vanek","year":"1952","journal-title":"Zentralbl Bakteriol Orig"},{"key":"2025082708192516000_16.7.e253563.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra032588"},{"key":"2025082708192516000_16.7.e253563.4","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1621"},{"key":"2025082708192516000_16.7.e253563.5","doi-asserted-by":"publisher","DOI":"10.1086\/339548"},{"key":"2025082708192516000_16.7.e253563.6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/10408379991249194","article-title":"Imaging features of Pneumocystis carinii pneumonia","volume":"40","author":"Crans","year":"1999","journal-title":"Crit Rev Diagn Imaging"},{"key":"2025082708192516000_16.7.e253563.7","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400190032008"},{"key":"2025082708192516000_16.7.e253563.8","unstructured":"Hacking C , Amini B . Pulmonary Pneumocystis Jiroveci infection [Radiopaedia.org]. 2008. 10.53347\/rID-1901"},{"key":"2025082708192516000_16.7.e253563.9","doi-asserted-by":"crossref","DOI":"10.1016\/j.chest.2019.08.768","article-title":"Necrotizing cavitary lung mass in patient with AIDS: a rare manifestation of Pneumocystis Jirovecii pneumonia","volume":"156","author":"Fadel","year":"2019","journal-title":"Chest"},{"key":"2025082708192516000_16.7.e253563.10","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-241061","article-title":"Pneumocystis pneumonia causing cavitating lung nodules in an immunocompetent individual","volume":"14","author":"Ojuawo","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082708192516000_16.7.e253563.11","article-title":"Unusual radiographic presentation of Pneumocystis pneumonia in a patient with AIDS","volume":"2017","author":"Block","year":"2017","journal-title":"Case Rep Infect Dis"},{"key":"2025082708192516000_16.7.e253563.12","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7329"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:19:32Z","timestamp":1756307972000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7,31]]},"published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1136\/bcr-2022-253563"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253563","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}