Case #282 – August, 2010

A 49-year-old man with AIDS was admitted to the hospital for complaints of a persisting fever and dry cough. A chest radiograph showed bilateral infiltrate. A sputum specimen was collected and stained with Giemsa, but no parasites were observed. A lung biopsy was obtained, sectioned, and stained with both methenamine silver and hematoxylin and eosin (H&E) stains. Figures A and B show what was observed at 500x magnification on one of the stained sections. What is your diagnosis? Based on what criteria?

Figure A

Figure B

Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.