The number of patients with altered cellular immunity has dramatically increased in recent years, mainly as a result of the acquired immunodeficiency syndrome (AIDS) epidemic.-2 Subsequently, the number of secondary infectious complications in these patients is also increasing. Pneumocystis carinii pneumonia (PCP), which was previously rare in humans, is the most common opportunistic infection in AIDS, occurring in 50 to 85 percent of patients. The increased incidence of PCP has allowed for more detailed descriptions of the manifestations of the disease.
Despite the rare mention of the possibility of pneumothorax in association with PCP in the early literature, several recent case reports and radiologic reviews have documented the association of cavities, pneumatoceles, or pneumothorax with PCP. To our knowledge, no study has assessed whether the increased incidence of pneumothorax is seen in all AIDS patients or only in those infected with P carinii. This retrospective review documents that in patients with AIDS, PCP is associated with a high incidence of pneumothorax, while AIDS patients without PCP have no apparent increased risk for the development of pneumothorax.
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