Sherman et al reported three cases of spontaneous pneumothorax associated with PCP and observed persistent bronchopleural fistulas in two of their three patients. Furthermore, tension pneumothorax has been described in association with PCP In addition to the high rate of resolution of pneumothorax observed in this study, it is also noteworthy that in six of […]
The pathophysiology of how PCP results in the formation of cysts, blebs, pneumatoceles, and eventual pneumothorax is unknown. Several mechanisms have been proposed for the cyst formation and presumed tissue destruction, including direct tissue toxicity by the organims, overdistention caused by inflamed bronchioles, and the prolonged presence of activated macrophages with the elaboration of elastase […]
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, […]
The three patients who received mechanical ventilation and PEEK however, were at increased risk for the development of pneumothorax, even in the absence of PCP.’ Perhaps the presence of PCP predisposed these patients to the development of pneumothorax by the formation of cysts, blebs, cavities, or pneumatoceles. Even when these three patients are excluded from […]
Streptococcus pneumoniae, and Streptococcus pyogenes, although rare cases of pneumatocele formation with Klebsiella pneumoniae, Haemophilus influenzae, Escherichia coli, Mycobacterium tuberculosis, Nocardia asteroides, various anaerobes, and P carinii have been described. Indeed, a review of PCP prior to the AIDS epidemic documented a 4 percent incidence of pneumothorax or pneumomediastinum in non-AIDS-associated PCP.
We asked whether the increased number of pneumothoraces described in AIDS patients was associated with P carinii itself or represented a risk for all patients with AIDS. For example, other potential risk factors for pneumothorax in these patients include intravenous drug use, invasive diagnostic procedures, other opportunistic pulmonary infections with subsequent lung destruction, human immunodeficiency […]
Discussion This retrospective review of all AIDS patients seen in the three largest teaching hospitals in Denver from May 1982 through April 1987 demonstrates an increased incidence of pneumothorax in patients with PCP (9.0 percent). Not a single case of pneumothorax was observed in AIDS patients without PCP All of the pneumothoraces resolved, most with […]
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