High-resolution CT findings of pneumocystis carinii pneumonia

High resolution CT (HRCT) was performed on 7 patients with pneumocystis carinii pneumonia (PCP). Six cases were proven bacteriologically by bronchoalveolar lavage; one case was proven by autopsy. Three patients were re-scanned after specific treatment and symptomatic relief. All the CT scans were abnormal, usually showing bilateral diffuse ground-glass opacity, through which the pulmonary vessels remained visible. Chest X-ray, on the other hand, showed a normal pattern in one patient. Other changes such as air space consolidation (in 4 cases) and thickening of peripheral pulmonary vessels (in 2 cases) were also seen. Air space consolidation was found in three cases with mixed infection (cytomegalovirus pneumonia in 2 cases, aspergillosis in one case). No patient showed significant mediastinal or hilar lymph node enlargement, pleural effusion or cystic pulmonary change. HRCT findings such as ground-glass opacity and air space consolidation were shown to disappear in some cases of PCP after specific treatment. HRCT is useful to evaluate the sequential pulmonary changes after the specific therapy. (author)