P273 Diagnostic dilemmas in Pneumocystis pneumonia in case of long COVID -19

Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Background To diagnose Pneumocystis pneumonia in an underlying COVID-19 infection is difficult because of the clinical and radiological indistinguishableness of the presentation. Case Presentation We report the case of a 67-year-old male background of type 2 diabetes mellitus (DM) and hypertension (HTN), who presented to the emergency department for severe dyspnea for 6 days. He is treated with corticosteroid and other supportive therapy. Initially, the patient responded with that treatment but suddenly his hypoxia is increasing and getting intubated. All possible causes of deterioration hypoxia were evaluated and came negative. Later stage, BAL was done and immunofluorescence test for PCP came positive. Systemic, cotrimoxazole started and gradually hypoxia improved and extubated. Conclusion Pneumocystis and COVID-19 co-infection needs serious consideration, particularly for patients with long-term COVID-19, even if patients do not have conventional risk factors for Pneumocystis pneumonia.