Open AccessThe diagnostic challenge of pneumocystis pneumonia and COVID ‐19 co‐infection in HIV
Author(s) -
Broadhurst Alistair G.B.,
Lalla Usha,
Taljaard Jantjie J.,
Louw Elizabeth H.,
Koegelenberg Coenraad F.N.,
Allwood Brian W.
Publication year - 2021
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.725
Subject(s) - medicine , pneumonia , covid-19 , human immunodeficiency virus (hiv) , pneumocystis pneumonia , pneumocystis carinii , intensive care medicine , intensive care unit , bronchoscopy , disease , immunology , pneumocystis jirovecii , infectious disease (medical specialty)
Coronavirus disease 2019 (COVID‐19) and pneumocystis pneumonia (PCP) share many overlapping features and may be clinically indistinguishable on initial presentation in people living with HIV. We present the case of co‐infection with COVID‐19 and PCP in a patient with progressive respiratory failure admitted to our intensive care unit where the dominant disease was uncertain. This case highlights the difficulty in differentiating between the two diseases, especially in a high HIV prevalence setting where PCP is frequently diagnosed using case definitions and clinical experience due to limited access to bronchoscopy, appropriate laboratory testing, and computed tomography scans. In addition, diagnostic testing may yield false‐negative results in both diseases, and clinician awareness to the overlap and pitfalls is essential if COVID‐19 becomes endemic in such settings.