Questions for Discussion:

  1. What is a differential diagnosis for his presentation?   Does the patient require isolation?
  2. What criteria define the diagnosis of AIDS (CDC criteria)?
  3. What work up should be performed to make diagnosis? Is empiric therapy warranted?
  4. PCP is identified from the sputum by direct fluorescence antibody stain in the clinical microbiology laboratory. What therapy should be administered?  
  5. The patient recovers completely from PCP pneumonia.   Following treatment course, would you recommend prophylaxis, and if so, with what agent?   What level CD4 count is associated with increased risk of PCP pneumonia?