1. Imaging of the week Dr.Anirudh J Shetty PROF.DR.DHANDAPANI’S UNIT

5. 34 yr old unmarried male ,c/o fever without chills –2 days; breathlessness & hemoptysis-1 day; h/o non productive cough + No h/o haematuria No h/o chest pain /PND /orthopnea Not a known DM/HT/TB/IHD/BA/ pt. O/E emaciated,thin ,dyspneic,tachypneic vitals-BP -110/80 mmHg CVS-S1 ,S2 heard RS- bil.BB + in infrascapular,mammary ,inframammary and infraaxillary areas bil.creps.+ other systems- NAD

6. SUMMARY; -CHEST X RAY PA VIEW -ADEQUATELY PENETRATED -INSPIRATORY FILM -PROPERLY CENTRED -TRACHEA IN THE MIDLINE -SOFT TISSUES & BONE NORMAL -HEART SHADOWS NORMAL NON HOMOGENOUS OPACITIES SEEN BILATERALLY IN THE MID AND LOWER ZONES MORE ON THE LEFT SIDE

7. DIFFERENTIAL DIAGNOSIS; ACUTE ALVEOLAR LUNG DISEASE “HEAP” Hemorrhage -Wegener granulomatosisSystemic lupus erythematosusGoodpasture syndrome Other vasculitides (e.g., polyarteritis nodosa, Henoch-Schönleinpurpura) Edema Alveolar proteinosis/Aspiration Pneumonia (includes infectious, organizing, and eosinophilic pneumonias)

8. Pneumocystis PNEUMONIA RADIOLOGY; - bilateral diffuse opacities, perihilarinitially,with a lower zone predominance”ground glass “opacities -later air space consolidation pattern ATYPICAL PRESENTATIONS -solitary/multiple ;solid /cavitory nodular opacities -cystic lung disease -enlarged noncalcified/calcifiedhilar/mediastinal nodes -pleural effusion -air filled cysts/pneumatoceles causing pneumothorax

11. CLINICAL FEATURES; non specific dyspnea,dry cough minimal signs –few crackles,wheeze unusual-asthma,hemoptysis,HPOA PCP related pneumothorax-sudden dyspneain AIDS patients

12. EXTRAPULMONARY PCP; Virtually every organ system can be affected heart thyroid bonemarrow brain git skin other manifestations include otitis media and externa, sinusitis n splenomegaly

13. Thank u