A forty-year old man with advanced acquired immune deficiency syndrome and bilateral pulmonary infiltrates

This report describes a 40-year old man with a history of acquired immunodeficiency syndrome (AIDS) diagnosed with Pneumocystis jiroveci pneumonia (PJP) twice prior to this admission, who presented with 3 days of fever, non-productive cough and shortness of breath. The patient was treated empirically for PJP, but his condition deteriorated rapidly and he expired despite resuscitative efforts. The bronchoalveolar lavage (BAL) and blood cultures grew Cryptococcus neoformans. Very few cases of disseminated cryptococcosis presenting as acute respiratory failure have been reported. Cryptococcosis is a common opportunistic infection that should be considered in patients with AIDS presenting with bilateral pulmonary infiltrates and fever.