Pneumothorax as the presenting sign of Pneumocystis carinii infection in an HIV-positive child with prior lymphocytic interstitial pneumonitis.
An HIV-positive child presented with a pneumothorax secondary to cavitary Pneumocystis carinii pneumonia (PCP). Lymphocytic interstitial pneumonitis had been evident on earlier radiographs but had resolved, concurrent with a decrease in her CD4 counts, before the radiographic changes of PCP became evident. As immune function declines in HIV-positive children, the chest radiograph may paradoxically clear. In such a setting, development of focal lung disease, including pneumothorax, may herald Pneumocystis carinii infection.
Solomon
K S
KS
Department of Radiology, Division of Pediatric Radiology, Babies & Children's Hospital of New York, Columbia-Presbyterian Medical Center, 3959 Broadway, BHN 3-318, New York, NY 10032, USA.
Levin
T L
TL
Berdon
W E
WE
Romney
B
B
Ruzal-Shapiro
C
C
Bye
M R
MR
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D018791:CD4 Lymphocyte Count; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000000981:diagnostic imaging*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging*; D008218:Lymphocytosis / Q000000981:diagnostic imaging*; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging*; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed