Evidence for Destruction of Lung Tissues During Pneumocystis carinii Infection

doi:10.1001/archinte.1987.00370040128022

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Vol. 147 No. 4, April 1987

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Evidence for Destruction of Lung Tissues During Pneumocystis carinii Infection

Robert H. K. Eng, MD; Eliahou Bishburg, MD; Sharon M. Smith, PhD

Arch Intern Med. 1987;147(4):746-749.

Abstract

• Five cases of Pneumocystis carinii infection with evidenceof lung tissue destruction that occurred in patients with theacquired immunodeficiency syndrome were reviewed. None of thepatients had a history of cigarette smoking, but all five hadeither cavitarylike lesions in the lungs or had pneumothoraxat the time of presentation to the hospital. All patients hadP carinii identified in specimens obtained either from bronchialwashings or from open-lung biopsy. In four of the five patients,no other pathogens were involved in the lungs, while the fifthpatient had concomitant cytomegalovirus infection. Findingson chest roentgenograms included large thin-walled cavitarylikelesions, multiple cavitary lesions, or pneumothorax. These presentationsof the infection have not been previously described, and themechanisms for lung tissue damage are as yet unknown. Cavitarylung disease found on chest roentgenograms in patients shouldnot exclude the diagnosis of P carinii pneumonia, and patientswith the acquired immunodeficiency syndrome presenting withpneumothorax should have the possibility of P carinii infectionincluded in the differential diagnosis.

(Arch Intern Med 1987;147:746-749)

Author Affiliations

From the Infectious Disease Section, Medical Service (Drs Eng and Bishburg), and the Microbiology Section, Laboratory Service (Dr Smith), Veterans Administration Medical Center, East Orange, NJ; and the Departments of Medicine (Drs Eng and Bishburg) and Pathology (Dr Smith), New Jersey Medical School/University of Medicine and Dentistry of New Jersey, Newark.

Footnotes

Accepted for publication Oct 27, 1986.

Reprint requests to Infectious Disease Section, Medical Service(111), Veterans Administration Medical Center, East Orange,NJ 07019 (Dr Eng).

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