Fever, Night Sweats and Weight Loss in an Asian Man: Not Always TB

A 36-year-old British born Asian man was admitted to hospital with a dry cough, fever of one-week duration and a two-day history of diarrhoea. He was eventually diagnosed with pneumocystis jirovecii pneumonia secondary to human immunodeficiency virus infection. This case was challenging diagnostically due to the lack of a complete history initially and full history not being available until later in the admission. A normal chest x-ray also complicated matters. Around 90% of patients with pneumocystis jirovecii pneumonia have chest x-ray changes. Following diagnosis using high resolution computed tomography scan and bronchoalveolar lavage and subsequent treatment with co-trimoxazole and antiretroviral therapy, the patient recovered uneventfully.