Pneumothorax with Pneumocystis carinii Pneumonia in AIDS (3)

In: Pulmonary function

13 Jun 2013

Pneumothorax with Pneumocystis carinii Pneumonia in AIDS (3)The size of the pneumothorax was approximated to be <15 percent (small), 15 to 50 percent (moderate), or >50 percent (large).
Statistics
The number of patients with PCP and pneumothorax was compared to the number of patients without PCP and pneumothorax by the difference proportion test. Probability values of <0.05 were considered significant.
Results
A total of 361 cases of AIDS were reported in Colorado between May 1982 and April 1987. Of the 361 patients, 261 (72 percent) had PCP on at least one occasion prior to the time of review. The three aforementioned teaching hospitals in Denver were responsible for the majority of care for 140 of the patients with AIDS. The charts of 134 of these 140 patients were available for review. Of these 134 patients, 89 (66 percent) had PCP, and the remaining 45 (34 percent) did not. Of the 45 patients without PCP, 25 (56 percent) had other pulmonary disease; nine had pleuropulmonary Kaposi’s sarcoma; seven, bacterial pneumonia; four, lymphoma; two, viral pneumonia; one, nonspecific pneumonitis; one, disseminated tuberculosis; and one, pulmonary edema. Eight (9.0 percent) of the 89 patients with PCP developed pneumothorax after a diagnosis of PCP was established (Table 1), compared with none (0 percent) of the 45 patients without PCP (p<0.03).

Table 1—Demographic and Clinical Characteristics of Patients with PCP and Pneumothorax

Patient/Sex/Age, yr HIVTransmission

Category

Diagnosis of PCP Coexisting Infection at time of PTX Risk Factor for PTX Size of PTX ChestTube Interval until Resolution, days
l/M/37 Heterosexual contact of IV drug user OLBx Cytomegalovirus Ventilator PEEP = 10 cm same day as R = PTX, 15 d before L = PTX >50% Bilateral 2
2/M/M Homosexual TBBx Cytomegalovirus Ventilator PEEP = 15 cm 5 d before R= PTX, 7 d before L = PTX >50% Bilateral 0
3/M/33 Homosexual TBBx DisseminatedCryptococcus Broviac catheter on right 3 d before R = PTX 15%-50% No 10
4/M/38 Homosexual TBBx None None <15% No 3
5/M/46 Homosexual Sputum Giemsa None Ventilator PEEP = 5 cm 2 d before bilateral PTX <15% No 9
6/M/25 Homosexual TBBx Mycobacteriumavium-intracellulare None >50% No 20
7/M/50 IV drug user Sputum Giemsa None None >50% No 15
8/M/29 Homosexual Sputum Giemsa None None >50% No 5

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