Chest
Volume 100, Issue 5, November 1991, Pages 1224-1228
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Clinical Investigations
Pneumothorax with Pneumocystis carinii Pneumonia in AIDS: Incidence and Clinical Characteristics

https://doi.org/10.1378/chest.100.5.1224Get rights and content

A retrospective review of the charts of patients with the acquired immunodeficiency syndrome (AIDS) was performed at three university-affiliated teaching hospitals in Denver between May 1982 and April 1987. Patients were evaluated for the presence or absence of Pneumocystis carinii pneumonia (PCP) and for the occurrence of pneumothorax at any time during their clinical course. The incidence of pneumothorax in AIDS patients with PCP was 9.0 percent (8/89), compared with 0 percent (0/45) in AIDS patients without PCP (p<0.03). All of the pneumothoraces resolved, most without chest tube placement. This study suggests that in patients with AIDS, PCP is associated with an increased incidence of pneumothorax, while AIDS patients without PCP are not at increased risk for the development of pneumothorax.

Section snippets

Case Review

Cases of AIDS in Colorado reported to the Denver Disease Control Service between May 1982 and April 1987 were reviewed. All patients had established AIDS, in accordance with the Centers for Disease Control 1985 surveillance definition.23 All cases at the three major university-affiliated teaching hospitals in Denver (Denver General Hospital, University of Colorado Health Sciences Center, and Denver Veterans Administration Hospital) were identified, and the patients' charts were reviewed in June

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

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 conservative managment.

In the 50 years following the original description of P carinii by Delano and Delano,28 the organism was considered to be an

Acknowledgments

The authors thank Jeanette Maez for typing the manuscript and Kent A. Penley for reviewing AIDS surveillance data.

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    Reprint requests: Dr. Cohn, 605 Bannock Street, Denver 80204

    Manuscript received December 10; revision accepted March 12.

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