1 Introduction:
Pneumocystis pneumonia (PCP) is an opportunistic infection commonly seen in individuals with weakened immune systems, particularly those living with HIV/AIDS [1, 2]. Despite the advancements in antiretroviral therapy, PCP remains a significant cause of morbidity and mortality in this population [3]. The diagnosis of PCP is challenging due to its non-specific clinical manifestations, which can mimic other infectious and non-infectious diseases [4,5]. In this case presentation, we discuss the clinical course of a 39-year-old male with persistent respiratory symptoms, including low-grade fever, weight loss, and a productive cough. Initial treatment with antibiotics proved ineffective, leading to further investigations. Chest X-ray and CT scan revealed characteristic radiological findings, and bronchial washings exhibited honeycomb-like alveolar casts. The patient’s positive HIV status supported a presumptive diagnosis of PCP. Timely initiation of appropriate treatment with Septran (sulfamethoxazole and trimethoprim) resulted in significant clinical improvement. This case highlights the importance of considering PCP in the differential diagnosis of respiratory symptoms in immunocompromised individuals and emphasizes the need for prompt diagnosis and management to improve patient outcomes.