TY - JOUR A2 - Snchez Prez, Hector Javier AU - Sullivan, Abigayle AU - Lanham, Theresa AU - Krol, Ronald AU - Zachariah, Shilla PY - 2020 DA - 2020/07/13 TI -Pneumocystis jiroveciiPneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/μL and Atovaquone Prophylaxis SP - 8532780 VL - 2020 AB - We describe a rare case of Pneumocystis jiroveciipneumonia (PCP) in a heterosexual man with a pertinent medical history of well-controlled human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) and PCP prophylaxis with atovaquone. The patient presented with recurrent shortness of breath, worsening malaise, and fever, following treatment for hypersensitivity pneumonitis one month prior, including a twenty-four-day course of 40 milligrams daily glucocorticoid with taper. However, transbronchial biopsies, lavage, and cytology from prior admission were inconclusive. The patient refused video-assisted thoracic surgery (VATS) at that time. Upon readmission, bronchoscopy with right VATS and lung biopsy were performed. Grocott’s methenamine silver stain of right lung biopsy was positive for Pneumocystis jirovecii。这种情况下是一种罕见的卡式肺囊虫肺炎病人的例子with a normal CD4 count (>487 cells/ μL) and a low viral load (<20 copies/mL) despite PCP prophylactic antibiotics in the setting of recent iatrogenic immunosuppression. SN - 2090-6625 UR - https://doi.org/10.1155/2020/8532780 DO - 10.1155/2020/8532780 JF - Case Reports in Infectious Diseases PB - Hindawi KW - ER -