Ure yeas “Tike Jugal wha veiw 1904 tosis * droge — serene tage t ofA Delanse 0 een ne oat ) qj gan Jecking Dak Mana Proumecyshs, fanisiis (442 rot corvidund axtogen of hua ter = Vanek « Tivoves established dhiias, asrcuation path lino Biseane ksitous wine” « aypemodsosr (305 cbe studs Ad to Aaweloymenr gf _ Pvienethamine Sulfdbkine' “eiatigaiin a) Aulamelnoragole . PATHOGEN « Alte Ufcté Eytraselluer obligate Asconeetous yore Aula anycett memprane > Lack oqosterol uth in cholesterol Antanas faratay Dyas! = Ngehes, AMG dapel Inaffectun cet wae + Ln amounts a cNilin aburtat polysaccharides = Alo, Maynox - eee cut “pie, ae ‘hasapoutie. tage ce a a aiid aga some 2 nos Spmahe GAEL AZ Siow cog wally Trorttogate > Tin walled sui ied, anebsnd + opuaye, aleurdar Revival ena amit WA TURE Chet, yy Te wale, qiemla contain upto e "jrophayeites an wsontial te ce 4 “i fewyst > ammahne wy & Ue & ropes a Aeoltbied Mature uysts Hor) et 1 sos : Ayeoti Sexual > a aptait 1 Armphopyits wedogo RelLare 1 ; ce oe meh rr wo unary fant 4 son Jpolieat Ywahne “pe[Mods framsmunim — Aisbome Risk FACTORS tell Aysyasction (he Neuhwpema SHypogarmmnaglabatlineneia gmmu nosupprestin IN HIV Injected patients , Mc pppartuniztic “ayextion bh fp 85% Wel fo Aovelsp POP > (D4 + Tel count — Lows than aop cells [HL > Cpa Tau percentage Ky re 3 Prev Hfo PEP. oval Landidiares —_ sivuspectve a Pk wunt Highwr WIV RNA Sovels Malnubihon 2 ar pat ef IRIS an Hiv. Negative Smmunceompromised patient , Highost incidence Aeon in (ordx) . HTLV-1 Amouiakd Aymphoma Scip Auile Lagrproughic. fleuheeniaSn Abid yen ‘ausplaute ations -* coq < Aso cell fue. re Rexdale gener tone ty h Prednisdine omy [day Xo weeks = suits ds lula Clinteal Resntatiny Symptoms > Fee, tah + Hyporenwa , Oittpraa PLHA tno ge fo Noy productive & Frank “Tathapnes mild Hypoxenia only im cunt Present fo ied OP 2 fo Bitch from SyMploms eniet Oe — BLNVESO ; rephratiny ates mi HIV - See : More xveu ines ¥epoxanuio. = Vey severe Ansig higrer Anns of supplemental 0. Icy admission 5 Mv. Presentohin Tine dy L week, rom gto tigadle Aigecon inflows nespome Disundance th presentahin Gs My BIV/ MIDs tm NON HIV Wiighes bundle ef organisms even & Araller Crgeruim lead ine) fective / (oo sinmune texpow Matrahy Aspen. by severe 6 qe yea anylatreve an in Longs lew agp Beth population Co anlectim 8% event & Peogessum { ne _ ey CMV, Hoteplasma, Mycbarkedium, legecrelle ia Pre egushy Aang fie 7 evel Extrapulmonry Preunronyt Re > Aeobplicd Pentamicire i : Gg Mu presentation Mars fabsun % fever * Gonstitunsnal Aytonptre © me On ope IM B Venn feuomeembolim 4 vasculils More Aewew in PLHIV > more commarty “cn brgans = ee» Ca > Remwowstrahin q P- proved in fone e 4 Paving eorinoprules mattial + clue Granulomatous Hamman | 1 cavities talirjecahars toy be @ ct Fecal anim anhancing dete attenuation Atay mim Ale J punduaté dalelications 7 sce feel Me in Liven | spleenRADIOLOGIG PATTERNS > | tunica + = Di Pilalaal , Interkihal Jnfeltrats — ¢ yr itt > Gago. Yo a Pal upt, Creimothorcy, csmadidatun, nodules ANTERSTITIAL PATTERN 5 Cre BIL ne patter epeuibion difion inlet, . : io, svteslitiat Atesia, Babel patan [ contrat predominanie 4 opasities 2, @ lay gor at the poughowy af dnber| ct AL intel pattan 2 attensiie 0. PULMONARY oysrs a Thin wall. - tm fo cm Nomenus . Mule ding. Aarons Ale Brnchicla, obshuchon , elaatite folsom Aang 4 duet tou destruchon mi oe ) Resolve aes autceu Mere Raph + PheurnotharaxPNEUMOTHORAX More common PLN HE 5 -20% Y pis © auphured Cyst Baha fom MV iatrogenic Cajter “trenacantons > Aeobsed PENTA MIDINE — Ran feaioy fia penton cous nce ae prophytanss ie Mc in Upper LOBES per Dit in HIV Neate patienss ey Bier aan OCH infesihat More umnmen (nprrates a partbron chovascutar ule PULMONAty NODULES SO asi Dit qearustarnores Tox poTe b dnfechin at Foy 2am @ a savdom ots 4 may Aye Me in pt & Amal magpie ay BAL alll be - ve dle encarement J ogame bg Granulorne Ex dative af Dats dilate00 =m me B FINDINGS cog & le mphoute count { ‘ CDA Count < a cab fae CPE cell cord ~ Ates (vig | Bet H Afbamin Plaumalyes + Orpoutre fo re Yar of anmodiid cellule aaitainny Aaa memban. Values > 8 RAlmi 9 aix rpeufieaty PPV 35 % > aso palm > 40/ ppv: >Sy. LPB >a Womb Ages f alevotimn — svelte & urdulyy Wapporseasn - Progra Malis aonihe Nor apenyie pi rai grey . Aerwolies , dathanain, — TOXplorrass , is tepasro Hepertaleunn Aue level ki-6 (Krebs von dan Luger fg) DIAGNOSIS HISTOPATHOLOGY : Hematorglin £ toxin + _cleesnot stain 1 forovedi 5 Aweals acellutes frarey eonopiilie exudate. in taminad alveoli @ Aangporabig | vouulatd -appeaaiue Neutroprils * Jugenphorrtss ~) Mfostiium Diff Atveolay dannsege tan be Aeon bub not peutic Granulomatra veyone — 0m ~ neevobiig / pomty revohaiy Ponulera Jack clanie feahner of aintia fic in Mint Hw/aips 4 Anamsppeatie | 4004 realigned - alveolar emp cxdatsCEL WALL STAINS (nsensi hve Whey, only stain the cell wall of cyst fem Hota, Het cells — atveriin culls» tracey hot stained : wie THE WAMINE Me stain wed St VER shun ( Grocott [ gongs vau‘ahey, ny 1 : black Uys (tup shaped) agdumk @ green basher, a pont i green Poteau oluidenn bux , per ath Wale, Caleafous ute Toluidene Hur ¢ Ousyd eke vider 9» purrte uypts (upshoed CAbe}iune wihute + Abdiny CHITIN: in to way Blu — white uysts Other Atauw used NUCLEAR © Cynic STAINS. tain all» f a Avrelsprrontal Ages { ned aersitity rain Ast ally (can oon ‘ ' punt 7 Giewa , Youihe Giemsa 4 Giema- Lie Atting “Frophpls ruuulsi + Appeas DEEP PURPLE Saint Aig BLUE fap._ ayes NUE cuerentin cogs epic eae arkibodls cecled a pneu! Us fare er wad . Ante ogni 00 % anne ane’ “ue rh s ITA Aeannigyn gone Used i 4 sep askep > , lo petite additonal ep t chromophore L nen a mathe Appees “Apple een." ls¥ pwcvmocyste SPEAFI per ASSAYS + tnghly pons Hire yea pry. hen aadidegi: * shinteat onteua ip ued as en pramient tolenigation 20" be Asreked Cewebintr Coum 173 & ucan 2 hos pette yd aw Aiyoontiane cslangalven eo “gnfectiow ct tan also , be wi & Aigjrent'ot yw calimni hon ; and injearn Aswor ak ty? ve pe & per eleSpeamen TYPES v Grdweed pat inhalivy aorosalized hypertonic alia _ obiaine | toi nebulizer st tain by cell wall [ruscleas stains ci Si - geneity: aso %% ih PLA is th 5 eer in Hiveve Cony fo ellwal) fe ye ana, & aj yA ued, gursitinty u bet 7 > mitial ral tt ( ra - st ee fa expesterated aparum — inadequak ep testy gy Srncho Palas Lavage: 4 GOL srordand * “ahould. be done 4 arent < modtuat, Aig aon ° Laoag mulhp tes & * ensitinty of dip ines, Lava fom uppa {6 non-invasive fot & ~ ve in, 4 ' iol) ve ase wilt Anveare yd, mm tly nine _. BAL cell wall staining # at. 0s burden 4 [or ford colt wall stain ve perf mer aes ama an >[ 9 at wash mere convenient, reasihie "fran induted = ~puhurs _, (e& intaatve Sample are oblatnel by allen ngerg gsml of BlowLe sale pe (0 AD 5D pees = geri Fivity depends ov urdestgirg Function @ Sune 4 x dove aith = vemithye PCR method, oral Warh sensitivity a adequate for inital Kew fe arpenred er 4) hug Propy call wall / nucley stains ax ced. senniinty a [swe in Hiv sve pabients DIAGNOSIS - CONSENSUS DEFINIToM Proven Aiageors _, Reteehin gf etgarai in Sputum, BAL Go ‘ Hara tse usirg usnventional methects / mrad wares atau) Pardpable ingress at fat ote ¥ cuntca + Respiratoy agmprone < Aadiogrophie hictorys in Host +» HIV /AtDs Cow othe, usndition Ladiiy to Cg < 20vcelbe, st call dapletirg. therary » : High doe unticotenid therapy > o3nylhg 4 2 2 rrede Aolid gen praruplantahsr positive By. 3-BD om acomeuchye samples om posite preLmoushs PR on Absypratory ApeimenPossible FeP —» rast + clinical no tyedtogial emdenu “TREATMENT y Trinetiicprin = Su [fancethoxegole i ee an aH HIV +e Dex - 15 bp dary [hate Avnded in 31 4 dovs fox Al days Modnat te swe — Iv dbseivs dno swith eal ope tre & clinicat anirorerent t z Dose aay, - fh A eae ; Pex 24tjunement in Kenad Iupaciacent: GI dohivbances , shun seals , drug poe Hypolalenia (by blockads 4 Distal Nephron Ni? channels ‘ ly THP) Creatinine elevation ( by @ o oetiune Aenehin bg THA) Sou adrewe offees Mae eth = Acll ard bu roma franplant weépent v ve ' Nephroto xray or § hansamunau oh Tye 2 Type 4 yeni syal < Naa eusersit phn& — PENTAMID INE tv - 41y My once dary by shoo ty 8 1 te vhy Sadeol fects — Nephrotorrecty Hypelenstin erhatron ins te A arin ERT EME dygquasen. hallecinahin prise te Ay damnnge of prcells 9 TP acleaw apreg wyecenia ane 4 fice s 4 ne. Lay Mypergtycemnes 3. 4M, d Clindernyctn 4 Primaqurne pref owed aaginio fe sailvage Masapy Clindamyeta = ov ~ grog Po | FT hiss aa Gov - Jovy wv oveny 6 fo shy Prinaguine =) 15 fo 30m wal bax ae ges - Methemaylsbinemr , 49 Atovoqusne v Bp efod “Tsvny / 91 eal aupenatsn fovra bu mele feet Pe, bitter fants berp > dlanhes wll5 Dap ¢ Tate tfrepnm ne - ITI svally Idaw Top = ng hy ley Methemagléti nena, a > DO rem ay unethre — Cotteastewds Mm modus P Arte Area Pao, < Tommitg at tA i © i A-a get at let 2m : Aedutee Dlatibed § only Adteunalen 4 Oxygenation , ©, mend §* my # death by Bunting inkeniqud tmmun spon ts, ditig gat thou be quien inthahen J for thoagy . > 6a Prodniron 40mg Bb x odays Fb past ff within Ten asty 6px od t Ado , te Mp 26my ox WU days mn Hiv ave, ABC titan wilhin 2 weer g POP thnopyIndications — Prophians ; PLuiv Zz es = not om At ze tpg x seocells [itch om AL 2b Coa « r00c0lb Jue ° Populares, Pay < wy, " A : a Perey ake = fh PLAW afte qa We qh Pep When (PG pevcetls fae & behpeen {to ¢ 290 cell, (MLE Urolebeetable iv visa bred (atleast 6 mmtty, ‘ - 2° prophylaris Can be dbomiinued + ae ee » All solid sae Haneplant Gscr ALL thax aceoniy tap Alemfugenab . Pol 2 lendwise inhibitrs . Jelelabisc rst $Me NI Protege Wwe q eee ofscaineiticert ie 2604 yn 4imeelstmp sax pss > daly @ [ps © daity om ps dhnie woul + HV Peo Atral frany, BE re fe foxepleamors 168 fabler Pevngqume isn carly = ped, EAprene SBP / (sony on erat ued Penta midi omy men Fly ewolltn ; ——— PLEIV 1° praphylax Au; ombruia : Cog g dsvcells / pt fe atteasr 5 matt seo and bevels «Undelete wal ond de Zh 6 MM Metiaus Hiv -ve j al) lid oan franipant —.. & Jo)2 wonth, Aen = [aw 4 Avvals bowel Dairyplana