Atypical radiographic manifestation in Pneumocystis jirovecii pneumonia

An 88yearold woman with rheumatoid arthritis (RA) was transferred to our hospital due to cough, fever, and hypoxia. She had received 8 mg of weekly methotrexate and 4 mg of daily prednisolone and had not been given Pneumocystis jirovecii pneumonia (PCP) prophylaxis. Her chest Xray showed consolidation of the left lower lung field (Figure 1), and chest computed tomography confirmed left lower lobe consolidation accompanied with air bronchogram (Figure 2). She was given a diagnosis of PCP based on her positive sputum Pneumocystis jirovecii PCR.