A 32 year-old male presents with dyspnea and a nonproductive cough. His is tachycardic, tachypneic and febrile. Auscultation of his chest reveals scattered rhonchi. His chest x-ray demonstrates a diffuse interstitial infiltrate. His ABG demonstrates moderate hypoxemia and his LDH is elevated. What is the most likely diagnosis?
A. Streptococcal pneumoniae pneumonia
B. Mycoplasma pneumoniae pneumonia
C. Pneumocystis carinii pneumonia
D. Bowen's disease
E. Steven-Johnson syndrome
Answer: C, Pneumocystis carinii pneumonia
Many AIDS patients present initially with PCP. These are the classic sns & sxs of PCP pneumonia. While mycoplasma patients can be acutely ill, they are more likely (especially on the Boards) to present as mildly ill with normal PE and no hypoxia. S. pneumo is the most common CAP, but would present with a focal/lobar consolidation.
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