BY MARIE ROSENTHAL, MS
A
t first, it was a puzzle—a 33-year-old man, formerly healthy with a two-month history of fevers of unknown origin, elevated liver enzymes, oral mucosa candidiasis and cytomegalovirus —who presented to the emergency room at UCLA Medical Center, in Los Angeles, with dyspnea. He died shortly afterward, and on post-mortem was found to have an unusual pneumonia, caused by Pneumocystis carinii —later renamed P. jirovecii —which typically affected people who were severely immunocompromised. But there was no evidence of a condition that would have impaired his immune system. One patient. An infectious disease curiosity, nothing more. But then there were others.
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