Spontaneous Pneumothorax in AIDS Patients with Recurrent Pneumocystis carinii Pneumonia Despite Aerosolized Pentamidine Prophylaxis

Fatal bilateral pneumothoraces following administration of aerosolised pentamidine

“…Neither patient suffered pneumothoraces during the delivery of AP. 42 In another report of pneumothoraces in six HIV positive patients with PCP, one had bilateral pneumothoraces. 36 Although the patient in this case had no evidence of PCP infection, it is possible that existing asthma-and emphysema-related damage played an equivalent role to infection in decreasing pulmonary reserve and increasing the risk of pneumothorax.…”

Management of AIDS-related bilateral pneumothorax and temporal arteritis

“…Another possible explanation is concurrent focal or diffuse parenchymal necrosis caused by acute or chronic PCP. The occurrence of AIDS-related PTX has also been associated with aerosolized pentamidine therapy with a direct toxic effect on lung tissue [14,15], intravenous drug abuse related septic emboli [6], a history of previous lung field irradiation and the use of tobacco and steroids [14].…”

“…Thus, he is not included in the cases of AIDS' patients with pneumocystis carinii's infection who are under aerosolized pentamidine [15]. He was under i.v antibiotics and corticosteroid therapy for giant It is generally agreed that these spontaneous PTXs in AIDS patients are more difficult to manage than those in patients without AIDS.…”

Pleural disease and acquired immune deficiency syndrome

“…The reason that there is a high incidence of spontaneous pneumothorax in AIDS patients with P. carinii infection appears to be the presence of multiple subpleural lung cavities, which are associated with subpleural necrosis [8][9][10][11]. Most AIDS patients with P. carinii infection and spontaneous pneumothorax will have evidence of fibrocystic parenchymal disease [8].…”