Twenty of the 45 patients without PCP did not have documented pulmonary complications of AIDS and therefore should not have been at increased risk for the development of pneumothorax. Twenty-five patients did have some form of pulmonary disease, including pleuropulmonary Kaposis sarcoma, bacterial pneumonia, lymphoma, viral pneumonia, nonspecific pneumonitis, disseminated tuberculosis, and pulmonary edema; however, pneumothorax developed in none of them. Although this report included a relatively small number of patients with non-PCP pulmonary disease, there was no observed increase in the incidence of pneumothorax in this group of patients. The presence of HIV itself does not seem to be a risk factor for the development of pneumothorax.
The possibility of selection bias needs to be considered, since all of the patients were seen in teaching hospitals. However, the proportion of AIDS patients with PCP in this study (66 percent) was consistent with the statewide proportion (72 percent), as well as the proportion of cases reported in the United States (62 percent). We believe that the epidemiologic and clinical characteristics of these patients are representative of those of most patients with PCP and AIDS.
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