A biopsy of the retina and choroid layer may be performed. In affected liver, biopsy shows focal areas of necrosis and sinusoidal widening. H&E staining show extracellular frothy pink material. Typical cysts with a solid dark dot can be seen using a Grocott silver stain. Differential diagnosis
Pneumocystosis may appear similar to pulmonary embolism or adult respiratory distress syndrome. Other infections can present similarly such as tuberculosis, Legionella, and severe flu. Prevention
There is no vaccine that prevents pneumocystosis. Trimethoprim/sulfamethoxazole (co-trimoxazole) might be prescribed for people at high risk. Treatment
Treatment is usually with co-trimoxazole. Other options include pentamidine, dapsone and atovaquone. Outcomes
It is fatal in 10-20% of people with HIV/AIDS. Pneumocystosis in people without HIV/AIDS is frequently diagnosed late and the death rate is therefore higher; 30-50%. Epidemiology
The exact number of people in the world affected is not known. Pneumocystosis affects lungs in around 97% of cases and is often fatal without treatment. History
The first cases of pneumocystosis affecting lungs were described in premature infants in Europe following the Second World War. It was then known as plasma cellular interstitial pneumonitis of the newborn.Pneumocystis jirovecii (previously called Pneumocystis carinii) is named for Otto Jírovec, who first described it in 1952. == References ==
Onycholysis is a common medical condition characterized by the painless detachment of the nail from the nail bed, usually starting at the tip and/or sides. On the hands, it occurs particularly on the ring finger but can occur on any of the fingernails. It may also happen to toenails. Onycholysis can occur in many conditions, including psoriasis. In thyrotoxicosis, it is thought to be due to sympathetic overactivity. It may also be seen in infections or trauma. Causes
Unknown
Trauma, excessive manicuring
Infection: especially fungal
Skin disease: psoriasis, dermatitis
Impaired peripheral circulation, e.g. Raynauds syndrome
Systemic disease: hyperthyroidism, hypothyroidism, reactive arthritis, porphyria cutanea tarda
Reaction to detergents (e.g. washing dishes with bare hands, using detergent-based shampoos or soaps). Patients with hepatocellular dysfunction may develop hair-thinning or hair loss and nail changes such as clubbing, leukonychia (whitening), or onycholysis, affecting the nails of the hands and feet. Onychomycosis (tinea)
It is common in ballet dancers
Chemotherapy (cytotoxic agents like taxanes, vinca alkaloids and others)
Chronic Renal Failure

Treatment
Most instances of onycholysis without a clear cause will heal spontaneously within a few weeks. The most commonly recommended treatment is to keep the nail dry as much as possible and allow the nail to slowly reattach. Trimming away as much loose nail as can be done comfortably will prevent the nail from being pried upwards. Cleaning under the nail is not recommended as this only serves to separate the nail further. Bandages are also to be avoided.