Extrapulmonary Pneumocystis Jirovecii Presenting as Fever and Lymphadenopathies. Case Report and Literature Review

Abstract

Pneumocystosis is one of the most common opportunistic infection occurring in HIV infected patients. The usual clinical presentation of Pneumocystis infection is pulmonary. Extrapulmonary Pneumocystis (EP) infections are uncommon, and have generally been observed in patients with advanced HIV disease, many times under second line prophylaxis with aerosolized pentamidine. Because of its low frequency, its low index of suspicion and a variety of clinical presentations, extrapulmonary forms of P. jirovecii infections are usually difficult to diagnose. We report a case of extrapulmonary pneumocystosis as a form of presentation of Acquired Immunodeficiency Syndrome (AIDS) presenting with fever and enlarged intra-abdominal lymph nodes, and review all published cases of extrapulmonary pneumocystosis from 1997 to 2017.