Lateral soft tissue radiographs of the neck will show evidence of tissue edema, and the tracheal air column may be deviated or compressed. Plain roentgenograms can be helpful in detecting free gas in the tissues produced by gasforming bacteria, or the presence of calcifications associated with Echinococcus or Pneumocystis infection [21]. The presence of soft-tissue gas foul-smelling pus suggests the presence of an anaerobic infection [10]. P. carinii thyroiditis has no specific clinical features and most individuals suffer from HIV and present with diffuse tender goiter [17].