Coronavirus Disease-19 Pneumonia or Pneumocystis carinii Pneumonia in a Patient with Diabetes: A Diagnostic Dilemma

Abstract

Coronavirus disease 2019 (COVID‐19) and pneumocystis pneumonia share many overlapping features and may be clinically indistinguishable on initial presentation in people living with human immunodeficiency virus severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) belongs to the subfamily of beta-coronavirus, which are responsible for respiratory, enteric, hepatic, and neurologic diseases, due to their broad tissue tropism. In the present patient, the course was acute with dyspnea being one of the major symptoms and lung involvement was seen to be peripheral. The two negative reverse transcription polymerase chain reaction (RT-PCR) reports for SARS-CoV-2 along with the differences in the interpretation of the computed tomography scans led to the diagnosis difficulty in the present case. COVID-19 pneumonia may have similar presentation like that of Pneumocystis carinii pneumonia. The low sensitivity of RT-PCR which is considered the gold standard of diagnosis of SARS-CoV-2 and the similarities in presentation between the two types of pneumonia, along with increased prevalence of both the types of pneumonia amongst diabetics, may give rise to diagnostic difficulties.