|A.||Bronchoscopy with bronchoalveolar lavage|
Examination of stool or respiratory excretion for eggs or worms
Acid-fast stain of stool
Urine antigen test
Ans. a. Bronchoscopy with bronchoalveolar lavage
Pneumocystis pneumonia (PCP) can present in patients with HIV as fever, cough, and dyspnea. Chest x-ray shows bilateral diffuse interstitial infiltrates. Pneumocystis jiroveci is a unicellular fungus that causes diffuse interstitial pneumonia in immunocompromised hosts. PCP pneumonia rarely, if ever, occurs in healthy individuals.
Diagnosis is done by the detection of the organism in the sputum with microscopy after silver staining.
Sometimes, induced sputum may not yield organisms. In such cases, bronchoscopy should be done to collect a sample with bronchoalveolar lavage.
Microscopy of the collected specimen is stained with methenamine silver stain or fluorescent antibody. It will reveal disc-shaped yeasts (“cup-in-saucer” appearance).