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Postgraduate Education Corner: CHEST IMAGING AND PATHOLOGY FOR CLINICIANS |

A Patient With HIV, Dyspnea, and Multiple Pulmonary Nodules

Manish Joshi, MD; Natalia Markelova, MD; Diana Palacio, MD; Ralph M. Schapira, MD, FCCP
Author and Funding Information

*From the Pulmonary and Critical Care Division (Drs. Joshi and Schapira), Division of Anatomic Pathology, Histology, and Surgical Pathology (Dr. Markelova), and Division of Radiology (Dr. Palacio), Medical College of Wisconsin, Milwaukee, WI.

Correspondence to: Manish Joshi, MD, Pulmonary and Critical Care Division, Medical College of Wisconsin, Milwaukee, WI 53226; mjoshi@mail.mcw.edu



Chest. 2006;130(6):1924-1928. doi:10.1378/chest.130.6.1924
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A 51-year-old, African-American, homosexual man with HIV infection for 5 years presented with worsening shortness of breath on exertion, dry cough, and generalized fatigue of 2 weeks in duration. He denied hemoptysis, fevers or chills, night sweats, diarrhea, dysuria, or weight loss. His medical history was significant for HIV-related diseases including Pneumocystis jirovecii (formerly Pneumocystis carinii) pneumonia, Candida esophagitis, adrenal insufficiency, and community-acquired pneumonia. He was a smoker but denied recent alcohol or illicit drug use. The patient was prescribed multiple medications including highly active antiretroviral therapy (HAART), dapsone for P carinii pneumonia prophylaxis, fluconazole, and fludrocortisone but was noncompliant with medications.

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