Respiratory distress, pneumonic changes on chest X-ray, hypoxaemia, oral candidiasis in a homosexual male: not always Pneumocystis carinii pneumonia.

A young homosexual male presented to the emergency department with respiratory distress, oropharyngeal candidiasis, hypoxaemia, and renal failure. Pneumocystis carinii pneumonia was considered to be the likely diagnosis - until 24 h later when the patient divulged the true history of paraquat ingestion some 5 days previously. Ingestion of corrosives should be considered in patients with oropharyngeal candidiasis and pneumonic symptoms, especially in the presence of renal failure as an alternative to HIV infection.